| Luke Carter, Lp, Llc | |
|
4601 E Douglas Ave Ste 207 Wichita KS 67218-1032 | |
| (316) 337-5556 | |
| (316) 337-5531 |
| Full Name | Luke Carter, Lp, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4601 E Douglas Ave Ste 207, Wichita, Kansas |
| Authorized Official Name and Position | Diana Miskiewicz (CREDENTIALING) |
| Authorized Official Contact | 3165191877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luke Carter, Lp, Llc 4601 E Douglas Ave Ste 207 Wichita KS 67218-1032 Ph: (316) 337-5556 | Luke Carter, Lp, Llc 4601 E Douglas Ave Ste 207 Wichita KS 67218-1032 Ph: (316) 337-5556 |
| NPI Number | 1538784848 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 03/28/2021 |
| Certification Date | 03/28/2021 |
| Medicare PECOS PAC ID | 9436572757 |
|---|---|
| Medicare Enrollment ID | O20200706000814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538784848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Luke E Carter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427238682 PECOS PAC ID: 3274688890 Enrollment ID: I20090903000554 |
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