Provider Demographics
NPI:1295300093
Name:FLORES, CARRI A (TLPC)
Entity type:Individual
Prefix:MRS
First Name:CARRI
Middle Name:A
Last Name:FLORES
Suffix:
Gender:F
Credentials:TLPC
Other - Prefix:MRS
Other - First Name:CARRI
Other - Middle Name:A
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TLPC
Mailing Address - Street 1:1635 S LOGAN PASS
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7914
Mailing Address - Country:US
Mailing Address - Phone:316-209-0796
Mailing Address - Fax:
Practice Address - Street 1:1855 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3413
Practice Address - Country:US
Practice Address - Phone:316-655-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS742822588101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor