Individual provider Active NPI

Laura Gwen Talley, PSY.D.

  • Clinical Psychologist
  • Lawrence, KS
National Provider Identifier
1215976568
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP-0913 Issued in KS
Practice address
5200 Bob Billings Pkwy
Suite 203
Lawrence, KS 66049-5810
Phone
(785) 842-3681
Fax
(785) 856-7595
NPI assigned
Jun 5, 2006
Last updated
Oct 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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 LP-0913 KS Primary

Addresses

Primary practice location

5200 Bob Billings Pkwy
Suite 203
Lawrence, KS 66049-5810

Mailing address

5200 Bob Billings Pkwy
Suite 203
Lawrence, KS 66049-5810
Phone (785) 842-3681

Other identifiers 1

IdentifierTypeStateIssuer
100241830 AMedicaidKS

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
I20050620000613 KS Practitioner - Clinical Psychologist 7911941091 Practice locations: Lawrence, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1311 Wakarusa Dr
Suite 2116
Lawrence, KS 66049-4775
Phone (785) 842-3681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP-0913KSMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rita Joy Stucky PHD., Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1215976568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 BOB BILLINGS PKWY",
            "address_2": "SUITE 203",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660495810",
            "telephone_number": "785-842-3681",
            "fax_number": "785-856-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 BOB BILLINGS PKWY",
            "address_2": "SUITE 203",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660495810",
            "telephone_number": "785-842-3681",
            "fax_number": "785-856-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "LAURA",
        "middle_name": "GWEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LP-0913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100241830 A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.