NPIMap

Organization Active NPI

Wsu Psychology Clinic

  • Clinical Psychologist
  • Wichita, KS
National Provider Identifier
1376244830
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WSU PSYCHOLOGY CLINIC
Practice address
Department of Psychology-Wsu Psychology Clinic
1845 Fairmount Street, Jabara Hall
Wichita, KS 67260
Phone
(316) 978-3170
Fax
(316) 978-3086
NPI assigned
Mar 13, 2023
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
WICHITA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Bryce Summers, PH.D.
Title
LP Clinic Director
Phone
(316) 978-3170

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X

Addresses

Primary practice location

Department of Psychology-Wsu Psychology Clinic
1845 Fairmount Street, Jabara Hall
Wichita, KS 67260

Mailing address

Department of Psychology-Wsu Psychology Clinic
1845 Fairmount St, Jabara Hall Campus Box 34
Wichita, KS 67260
Phone (316) 978-3170

National Provider Directory

National Provider Directory
Tax ID family
Wichita State University5 organizations share this tax ID, including this one
Part of
Wichita State University

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1376244830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHOLOGY-WSU PSYCHOLOGY CLINIC",
            "address_2": "1845 FAIRMOUNT ST, JABARA HALL CAMPUS BOX 34",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67260",
            "telephone_number": "316-978-3170",
            "fax_number": "316-978-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHOLOGY-WSU PSYCHOLOGY CLINIC",
            "address_2": "1845 FAIRMOUNT STREET, JABARA HALL",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67260",
            "telephone_number": "316-978-3170",
            "fax_number": "316-978-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WSU PSYCHOLOGY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WICHITA STATE UNIVERSITY",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_title_or_position": "LP CLINIC DIRECTOR",
        "authorized_official_telephone_number": "316-978-3170",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 13, 2023; 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.