Active NPI
Michelle Polvadore
- School Psychologist
- Wichita, KS
National Provider Identifier
1245142694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 5813682783
- Practice address
- 1544 N Governeour Rd
Wichita, KS 67206-1156 - Phone
- (316) 973-3949
- NPI assigned
- Sep 21, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 5813682783 | KS | Primary |
Addresses
Primary practice location
1544 N Governeour Rd
Wichita, KS 67206-1156
Mailing address
30 Shadybrook Dr
Wellington, KS 67152-4729
Phone (620) 705-1095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789948800000",
"number": "1245142694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 SHADYBROOK DR",
"city": "WELLINGTON",
"state": "KS",
"postal_code": "671524729",
"telephone_number": "620-705-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1544 N GOVERNEOUR RD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672061156",
"telephone_number": "316-973-3949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLVADORE",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-21",
"last_updated": "2026-09-21",
"certification_date": "2026-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "KS",
"license": "5813682783",
"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 Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.