Individual provider Active NPI

Autumn Taya Pourhussin, MS, LMLP-T

  • Counseling Psychologist
  • Wichita, KS
National Provider Identifier
1194535781
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
03386 Issued in KS
Practice address
8100 E 22ND St N Ste 100
Wichita, KS 67226-2350
Phone
(316) 201-6047
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 03337-T KS
Counseling Psychologist 103TC1900X 03386 KS Primary

Addresses

Primary practice location

8100 E 22ND St N Ste 100
Wichita, KS 67226-2350

Mailing address

1837 Drollinger St
Wichita, KS 67218-4705
Phone (316) 393-8792

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
03337-TKSMDClinical Psychologist
03386KSMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1194535781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 DROLLINGER ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672184705",
            "telephone_number": "316-393-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 E 22ND ST N STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262350",
            "telephone_number": "316-201-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURHUSSIN",
        "first_name": "AUTUMN",
        "middle_name": "TAYA",
        "credential": "MS, LMLP-T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "03337-T",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KS",
            "license": "03386",
            "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 Mar 7, 2025; 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.