| Emporia Psychological Services Inc | |
|
702 Commercial St Ste 3b Emporia KS 66801-3093 | |
| (620) 342-1998 | |
| Not Available |
| Full Name | Emporia Psychological Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 702 Commercial St Ste 3b, Emporia, Kansas |
| Authorized Official Name and Position | Timothy Sippola (OWNER) |
| Authorized Official Contact | 6203421998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emporia Psychological Services Inc 702 Commercial St Ste 3b Emporia KS 66801-3093 Ph: (620) 342-1998 | Emporia Psychological Services Inc 702 Commercial St Ste 3b Emporia KS 66801-3093 Ph: (620) 342-1998 |
| NPI Number | 1780961425 |
|---|---|
| Provider Enumeration Date | 11/09/2011 |
| Last Update Date | 06/20/2018 |
| Medicare PECOS PAC ID | 5092982280 |
|---|---|
| Medicare Enrollment ID | O20120111000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780961425 | NPI | - | NPPES |
| P00285242 | Other | KS | RAILROAD MEDICARE |
| 119025 | Other | KS | BCBS OF KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0523 (Kansas) | Primary |
| Provider Name | Timothy S Sippola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508958992 PECOS PAC ID: 4183891385 Enrollment ID: I20120111000216 |
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