Individual provider Active NPI

Charles Lucas Stephens, LMLP, LCP

  • Group Psychotherapy Psychologist
  • Dodge City, KS
National Provider Identifier
1245355361
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
0136 Issued in KS
Practice address
11200 Lariat Way
Dodge City, KS 67801-7328
Phone
(620) 225-0276
Fax
(620) 225-0276
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0141 KS
Psychologist 103T00000X 0136 KS
Group Psychotherapy Psychologist 103TP2701X 0141 KS
Group Psychotherapy Psychologist 103TP2701X 0136 KS Primary

Addresses

Primary practice location

11200 Lariat Way
Dodge City, KS 67801-7328

Mailing address

900 W Broadway St
Newton, KS 67114-2037
Phone (316) 283-1950

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
I20240206003910 KS Practitioner - Mental Health Counselor 4587007547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iroquois Center for Human Development, Inc.Group PAC ID 2062314081, 7 clinicians

Practice addresses (Care Compare)

610 E Grant Ave
Greensburg, KS 67054-2708
Phone (620) 723-2272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0136KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Center for Human Development, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Iroquois Center for Human Development, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

610 E Grant Ave
Greensburg, KS 67054
Phone (620) 723-2272

Organizations & group practices 2

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245355361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W BROADWAY ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671142037",
            "telephone_number": "316-283-1950",
            "fax_number": "316-283-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LARIAT WAY",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017328",
            "telephone_number": "620-225-0276",
            "fax_number": "620-225-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "CHARLES",
        "middle_name": "LUCAS",
        "name_prefix": "Mr.",
        "credential": "LMLP, LCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "0141",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "0136",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "KS",
            "license": "0141",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "KS",
            "license": "0136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

Verify at the official NPI Registry.