Organization Active NPI

In His Image Christian Counseling, LLC

  • Clinical Social Worker
  • Garden City, KS
National Provider Identifier
1124435151
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KS1646 Issued in KS
Legal business name
IN HIS IMAGE CHRISTIAN COUNSELING, LLC
Practice address
201 E Laurel St
Garden City, KS 67846-5538
Phone
(620) 272-9506
Fax
(620) 272-9833
NPI assigned
Jul 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Doris M. Arwine, LSCSWNPI 1922038033
Title
Clinical Social Work Therapist
Phone
(620) 272-9506

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X KS1646 KS Primary

Addresses

Primary practice location

201 E Laurel St
Garden City, KS 67846-5538

Mailing address

201 E Laurel St
Garden City, KS 67846-5538
Phone (620) 272-9506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150224000382 KS Part B Supplier - Clinic/Group Practice 5597081216 Receives reassigned benefits from 1 practitioner
Practice locations: Garden City, KS

National Provider Directory

National Provider Directory

Locations

201 E Laurel St
Garden City, KS 67846
Phone (224) 201-6861

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1124435151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LAUREL ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465538",
            "telephone_number": "620-272-9506",
            "fax_number": "620-272-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LAUREL ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465538",
            "telephone_number": "620-272-9506",
            "fax_number": "620-272-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HIS IMAGE CHRISTIAN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "ARWINE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORK THERAPIST",
        "authorized_official_telephone_number": "620-272-9506",
        "authorized_official_credential": "LSCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "KS1646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.