Deidre Manis, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

DEIDRE MANIS, LLC

Practice address

7807 E Funston St
Wichita, KS 67207-3123

Phone

(316) 636-1188

Fax

(316) 636-1190

NPI assigned

Dec 8, 2020

Organization subpart

No

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

Authorized official

Name

Deidre Manis, LSCSW, LCAC

Title

Clinical Social Worker

Phone

(620) 875-9656

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1356947089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 N MEADOW RD",
            "city": "VALLEY CENTER",
            "state": "KS",
            "postal_code": "671479400",
            "telephone_number": "620-875-9656",
            "fax_number": "316-636-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 E FUNSTON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672073123",
            "telephone_number": "316-636-1188",
            "fax_number": "316-636-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIDRE MANIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "MANIS",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "620-875-9656",
        "authorized_official_credential": "LSCSW, LCAC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Degraftenreed
• Dylan Degroot
• William Judson Degroot
• Arthur D Dehart, MD
• Regan Dehart, MD
• Shelby Deist
• Daniel James Dejong, MD
• Steven Dejong
• Kayla Del Rio, APRN
• Angela Michelle Delamore, RN BSN, NC-BC

• Adult Mental Health Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Adult Mental Health Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.