Provider Demographics
NPI:1245622786
Name:AHRING, RAILENE KAY (LAC PCCM)
Entity type:Individual
Prefix:
First Name:RAILENE
Middle Name:KAY
Last Name:AHRING
Suffix:
Gender:F
Credentials:LAC PCCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 6TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-1401
Mailing Address - Country:US
Mailing Address - Phone:913-755-2081
Mailing Address - Fax:913-755-2083
Practice Address - Street 1:223 6TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1401
Practice Address - Country:US
Practice Address - Phone:913-755-2081
Practice Address - Fax:913-755-2083
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLAC 155101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201102230AMedicaid