NPIMap

Organization Active NPI

Center for Counseling and Consultation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Great Bend, KS
National Provider Identifier
1104862549
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
004-06302011 Issued in KS
Legal business name
CENTER FOR COUNSELING AND CONSULTATION
Practice address
5815 Broadway Ave
Great Bend, KS 67530-3123
Phone
(620) 792-2544
Fax
(620) 792-7052
NPI assigned
Jun 22, 2006
Last updated
May 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Authorized official

Name
Dr. Patrick W Stang, MDNPI 1639100183
Title
Clin Dir
Phone
(620) 792-2544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 004-06302011 KS Primary

Addresses

Primary practice location

5815 Broadway Ave
Great Bend, KS 67530-3123

Mailing address

5815 Broadway Ave
Great Bend, KS 67530-3123
Phone (620) 792-2544

Other identifiers 1

IdentifierTypeStateIssuer
100098090AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050325000690 KS Part B Supplier - Clinic/Group Practice 2961458518 Receives reassigned benefits from 26 practitioners
Practice locations: Great Bend, KS

National Provider Directory

National Provider Directory
Tax ID family
Center for Counseling and Consultation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5501 10th St
Great Bend, KS 67530

217 East Ave N
Lyons, KS 67554
Phone (620) 257-5984

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1104862549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303123",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303123",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COUNSELING AND CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "STANG",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CLIN DIR",
        "authorized_official_telephone_number": "620-792-2544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "KS",
            "license": "004-06302011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098090A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.