| Southeast Kansas Mental Health Center | |
|
1106 S 9th St Humboldt KS 66748-1934 | |
| (620) 473-2241 | |
| (620) 473-3334 |
| Full Name | Southeast Kansas Mental Health Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1106 S 9th St, Humboldt, Kansas |
| Authorized Official Name and Position | Nathan Fawson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6203658641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Kansas Mental Health Center 1106 S 9th St Humboldt KS 66748-1934 Ph: (620) 473-2241 | Southeast Kansas Mental Health Center 1106 S 9th St Humboldt KS 66748-1934 Ph: (620) 473-2241 |
| NPI Number | 1801937669 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 05/27/2025 |
| Certification Date | 05/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801937669 | NPI | - | NPPES |
| 3000391474 | Medicaid | KS | |
| 006901 | Other | KS | BLUE SHIELD |
| 100098050C | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Southeast Kansas Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1106 S 9th St, Humboldt, KS 66748 Phone: 620-473-2241 Fax: 620-473-3334 |