| Simply Authentic Therapy, Llc | |
|
250 N Rock Rd Ste 270 Wichita KS 67206-2265 | |
| (316) 617-0065 | |
| Not Available |
| Full Name | Simply Authentic Therapy, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 250 N Rock Rd Ste 270, Wichita, Kansas |
| Authorized Official Name and Position | Shawna Kay Latimer (OWNER) |
| Authorized Official Contact | 3166170065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simply Authentic Therapy, Llc 250 N Rock Rd Ste 270 Wichita KS 67206-2265 Ph: (316) 617-0065 | Simply Authentic Therapy, Llc 250 N Rock Rd Ste 270 Wichita KS 67206-2265 Ph: (316) 617-0065 |
| NPI Number | 1164245718 |
|---|---|
| Provider Enumeration Date | 11/04/2024 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/03/2024 |
| Medicare PECOS PAC ID | 5294250965 |
|---|---|
| Medicare Enrollment ID | O20250416000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164245718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Shawna Latimer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497205405 PECOS PAC ID: 2365967767 Enrollment ID: I20250416000541 |
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