Active NPI
Glenn J Veenstra, PHD
- Clinical Psychologist
- Wichita, KS
National Provider Identifier
1285696922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0507
- Practice address
- 7829 E Rockhill St
Suite #105
Wichita, KS 67206-3920 - Phone
- (316) 293-3850
- Fax
- (316) 683-6733
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0507 | KS | Primary |
Addresses
Primary practice location
7829 E Rockhill St
Suite #105
Wichita, KS 67206-3920
Mailing address
1010 N Kansas
Suite #3049
Wichita, KS 67214-3199
Phone (316) 293-2647
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04414 | Other | KS | BCBS |
| 100237810A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 507 | KS | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1285696922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 N KANSAS",
"address_2": "SUITE #3049",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143199",
"telephone_number": "316-293-2647",
"fax_number": "316-293-1882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7829 E ROCKHILL ST",
"address_2": "SUITE #105",
"city": "WICHITA",
"state": "KS",
"postal_code": "672063920",
"telephone_number": "316-293-3850",
"fax_number": "316-683-6733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEENSTRA",
"first_name": "GLENN",
"middle_name": "J",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-06",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "0507",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "04414",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100237810A",
"state": "KS"
}
],
"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 Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.