Individual provider Active NPI

Tara M. Lancelot, LCMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1013153410
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
774 Issued in KS
Practice address
7926 W 21St St N
Wichita, KS 67205-1742
Phone
(316) 272-5502
Fax
(316) 830-4169
NPI assigned
Jan 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 774 KS Primary

Addresses

Primary practice location

7926 W 21St St N
Wichita, KS 67205-1742

Mailing address

6700 W Central Ave Ste 106
Wichita, KS 67212-6302
Phone (316) 516-8891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
774KSMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
KJM Ventures Inc PastSince Dec 17, 2023 Accepting new patients
Restoration Counseling & Consultation, P.a. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1013153410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 W CENTRAL AVE STE 106",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672126302",
            "telephone_number": "316-516-8891",
            "fax_number": "316-945-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 W 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051742",
            "telephone_number": "316-272-5502",
            "fax_number": "316-830-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCELOT",
        "first_name": "TARA",
        "middle_name": "M.",
        "name_prefix": "Miss",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.