| Amanda Wade, LPC | |
|
200 Commodore St, Pratt, KS 67124-2903 | |
| (620) 450-1163 | |
| Not Available |
| Full Name | Amanda Wade |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 200 Commodore St, Pratt, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164136271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LPC3578 (Kansas) | Primary |
| Entity Name | Pratt Regional Medical Center Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578596904 PECOS PAC ID: 1355253238 Enrollment ID: O20040419001344 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Wade, LPC 200 Commodore St, Pratt, KS 67124-2903 Ph: () - | Amanda Wade, LPC 200 Commodore St, Pratt, KS 67124-2903 Ph: (620) 450-1163 |
Beth Barnard, LMAC, LPC-T Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 W 4th St, Pratt, KS 67124 Phone: 620-672-7546 Fax: 580-824-0676 | |
Samantha Bauer, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 W 4th St, Pratt, KS 67124 Phone: 620-231-5310 | |
Kimberly Keiser, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 805 Larimer St, Pratt, KS 67124 Phone: 620-388-3057 | |
Miss Tamara Leaann Johnston, LMSW, LMAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 501 S Ninnescah St, Pratt, KS 67124 Phone: 620-672-7546 Fax: 620-672-7148 | |
Jessica Davis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 315 S High Street, Pratt, KS 67124 Phone: 620-388-1356 |