Firststarr Rehabilitation & Behavioral Health, LLC

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

1061 Issued in KS

Legal business name

FIRSTSTARR REHABILITATION & BEHAVIORAL HEALTH, LLC

Practice address

4402 E Central Ave
Wichita, KS 67208-3912

Phone

(316) 201-1273

Fax

(316) 260-9389

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Abiola Olusola Dipeolu, PH.D.

Title

Clinical Director

Phone

(316) 201-1273

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245278134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 E CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083912",
            "telephone_number": "316-201-1273",
            "fax_number": "316-260-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 E CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083912",
            "telephone_number": "316-201-1273",
            "fax_number": "316-260-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRSTSTARR REHABILITATION & BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIPEOLU",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_middle_name": "OLUSOLA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "316-201-1273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "KS",
            "license": "1061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Cognitive & Behavioral Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.