Individual provider Active NPI

Myranda Conley, LCPC

  • Professional Counselor
  • Wichita, KS
National Provider Identifier
1215536594
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
03536 Issued in KS
Practice address
2118 N Tyler Rd.
Building B, Suite 100
Wichita, KS 67212
Phone
(316) 800-1118
Fax
(316) 747-8597
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 03536 KS Primary

Addresses

Primary practice location

2118 N Tyler Rd.
Building B, Suite 100
Wichita, KS 67212

Mailing address

2118 N Tyler Rd Ste 100
Wichita, KS 67212-4912
Phone (316) 800-1118

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
I20240120000253 KS Practitioner - Mental Health Counselor 7315399821 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03536KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Meek Family Therapy Group LLC CurrentSince Dec 15, 2023 Accepting new patients

Locations

1525 N Buckner St
Derby, KS 67037
Phone (316) 788-6464

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1215536594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 N TYLER RD STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124912",
            "telephone_number": "316-800-1118",
            "fax_number": "316-747-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 N TYLER RD.",
            "address_2": "BUILDING B, SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-800-1118",
            "fax_number": "316-747-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "MYRANDA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.