Individual provider Active NPI

Susan G Summers, LCPC, LCAC

  • Professional Counselor
  • Wichita, KS
National Provider Identifier
1124464060
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2870 Issued in KS
Practice address
12828 E 13TH St N Ste 10
Wichita, KS 67230-1466
Phone
(316) 395-9694
Fax
(888) 356-0015
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 256 KS
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 2870 KS Primary

Addresses

Primary practice location

12828 E 13TH St N Ste 10
Wichita, KS 67230-1466

Mailing address

12828 E 13TH St N Ste 10
Wichita, KS 67230-1466
Phone (316) 395-9694

Other identifiers 1

IdentifierTypeStateIssuer
201121930AMedicaidKS

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
I20231222002569 KS Practitioner - Mental Health Counselor 1355791807 Practice locations: Wichita, KS

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2400 N Woodlawn Blvd
Suite 110
Wichita, KS 67220-3956
Phone (316) 260-1127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
256KSMDProfessional Counselor
2870KSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1124464060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12828 E 13TH ST N STE 10",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672301466",
            "telephone_number": "316-395-9694",
            "fax_number": "888-356-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12828 E 13TH ST N STE 10",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672301466",
            "telephone_number": "316-395-9694",
            "fax_number": "888-356-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "LCPC, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "256",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "2870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201121930A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.