| Resolutions Individual, Couple And Family Therapy Llc | |
|
982 N Tyler Rd Suite B Wichita KS 67212-3271 | |
| (316) 721-8118 | |
| (316) 721-8139 |
| Full Name | Resolutions Individual, Couple And Family Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 982 N Tyler Rd, Wichita, Kansas |
| Authorized Official Name and Position | Kevin P. Moore (OWNER) |
| Authorized Official Contact | 3167218118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resolutions Individual, Couple And Family Therapy Llc 982 N Tyler Rd Suite B Wichita KS 67212-3271 Ph: (316) 721-8118 | Resolutions Individual, Couple And Family Therapy Llc 982 N Tyler Rd Suite B Wichita KS 67212-3271 Ph: (316) 721-8118 |
| NPI Number | 1609088319 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 09/02/2015 |
| Medicare PECOS PAC ID | 7416276936 |
|---|---|
| Medicare Enrollment ID | O20150505002504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609088319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 338 (Kansas) | Primary |
| Provider Name | Shonda L Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508834961 PECOS PAC ID: 4183705734 Enrollment ID: I20080121000349 |
| Provider Name | Virgil Miller |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1639680663 PECOS PAC ID: 4587098793 Enrollment ID: I20191221000089 |
| Provider Name | Jessica Poell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972067403 PECOS PAC ID: 1052723608 Enrollment ID: I20201223002404 |
| Provider Name | Lauren A Macpherson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477730489 PECOS PAC ID: 2668887795 Enrollment ID: I20210223000361 |
| Provider Name | Christine Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316433972 PECOS PAC ID: 1658777867 Enrollment ID: I20210913002502 |
| Provider Name | Deanna M Ecklund |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396160628 PECOS PAC ID: 0042618001 Enrollment ID: I20211006001771 |
| Provider Name | Melba Mcgilvrey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245425792 PECOS PAC ID: 0547610412 Enrollment ID: I20231219002844 |
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