Provider Demographics
NPI:1932897428
Name:FORTIS, LLC
Entity Type:Organization
Organization Name:FORTIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DUSTI
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMFT, RPT
Authorized Official - Phone:913-244-0648
Mailing Address - Street 1:5 STUBBLEFIELD LN
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-8503
Mailing Address - Country:US
Mailing Address - Phone:913-244-0648
Mailing Address - Fax:913-490-2967
Practice Address - Street 1:5 STUBBLEFIELD LN
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-8503
Practice Address - Country:US
Practice Address - Phone:913-244-0648
Practice Address - Fax:913-490-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty