Individual provider Active NPI

Brenda L Trammel, LCP

  • Clinical Psychologist
  • Wichita, KS
National Provider Identifier
1194763680
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1457 Issued in KS
Practice address
6611 E Central Ave Ste C
Wichita, KS 67206-1937
Phone
(316) 993-2715
Fax
(866) 316-4467
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1457 KS Primary

Addresses

Primary practice location

6611 E Central Ave Ste C
Wichita, KS 67206-1937

Mailing address

6611 E Central Ave Ste C
Wichita, KS 67206-1937
Phone (316) 993-2715

Other identifiers 2

IdentifierTypeStateIssuer
392674OtherKSBLUE CROSS BLUE SHIELD
200430940FMedicaidKS

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
I20240325003146 KS Practitioner - Mental Health Counselor 5991010381 Practice locations: Wichita, KS

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6611 E Central Ave
Suite C
Wichita, KS 67206-1937
Phone (316) 648-1157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1457KSMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1194763680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 E CENTRAL AVE STE C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061937",
            "telephone_number": "316-993-2715",
            "fax_number": "866-316-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 E CENTRAL AVE STE C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061937",
            "telephone_number": "316-993-2715",
            "fax_number": "866-316-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMMEL",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "392674",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200430940F",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.