Provider Demographics
NPI:1780961425
Name:EMPORIA PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:EMPORIA PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SIPPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:620-342-1998
Mailing Address - Street 1:1402 EXCHANGE CT
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5272
Mailing Address - Country:US
Mailing Address - Phone:620-481-0100
Mailing Address - Fax:
Practice Address - Street 1:1402 EXCHANGE CT
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-5272
Practice Address - Country:US
Practice Address - Phone:620-342-1998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0523103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00285242OtherRAILROAD MEDICARE
KS119025OtherBCBS OF KS
KS=========OtherAMERICAN MEDICAL SECURITY
KS=========OtherASSURANT HEALTH/FORTIS
KS=========OtherFISERV
KS=========OtherHEALTH PARTNERS OF KANSAS
KS=========OtherBANKER'S LIFE & CASUALTY
KS=========OtherCOOPERATIVE BENEFIT ADMIN
KS=========OtherTRIWEST
KS=========OtherVALUE OPTIONS
KS=========OtherFMH BENEFIT SERVICES
KS=========OtherUNITED HEALTH CARE
KS=========OtherPREFERRED HEALTH SYSTEMS
KSP00285242OtherRAILROAD MEDICARE
KS=========OtherCIGNA
KS=========OtherFEDERATED INSURANCE
KS=========OtherCENTURY HEALTH SOLUTIONS
KS=========OtherAETNA 60054
KS=========OtherUNITED BEHAVIORAL HEALTH