Individual provider Active NPI

Chris Woodward, LCAC

  • Addiction (Substance Use Disorder) Counselor
  • Olathe, KS
National Provider Identifier
1104210541
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
00852 Issued in KS
Practice address
407 S Clairborne Rd Ste 207
Olathe, KS 66062-1744
Phone
(913) 276-7010
Fax
(855) 348-3430
NPI assigned
Mar 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00852 KS Primary

Addresses

Primary practice location

407 S Clairborne Rd Ste 207
Olathe, KS 66062-1744

Mailing address

407 S Clairborne Rd Ste 207
Olathe, KS 66062-1744
Phone (913) 648-2266

Other identifiers 1

IdentifierTypeStateIssuer
200408400AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626003396 KS Practitioner - Mental Health Counselor 9133692460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

407 S Clairborne Rd
Suite 104
Olathe, KS 66062-1744

PO Box
Suite 5478
Pawtucket, RI 02862-5478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00852KSMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Avenues to Recovery 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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1104210541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 207",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-648-2266",
            "fax_number": "855-348-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 207",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-276-7010",
            "fax_number": "855-348-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200408400A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.