Kethlyn Ann Staab, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3154 Issued in KS

Practice address

1600 N Lorraine St Ste 202
Hutchinson, KS 67501-5600

Phone

(620) 663-7595

Fax

(620) 663-5263

NPI assigned

Sep 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healing Life Therapy, LLC

  • Marriage & Family Therapist
  • Wichita, KS
  • NPI 1730944984
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1487204707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N LORRAINE ST STE 202",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675015600",
            "telephone_number": "620-663-7595",
            "fax_number": "620-513-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N LORRAINE ST STE 202",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675015600",
            "telephone_number": "620-663-7595",
            "fax_number": "620-663-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "KETHLYN",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "3088",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiths Food & Drug Centers Inc
• Savannah Elise Snell, PA
• Robert Sourk, MD
• Southwind Oral and Facial Surgery LLC
• Audrey N Sperber, LMSW
• Brenda M Staggs, PTA
• Robert Staggs, PA-C
• Jack Dean Stanfield Jr., D.C.
• David J Starkey
• Valerie K Steele, LMSW

• Marriage & Family Therapist in Hutchinson, KS
• Providers in Hutchinson, KS by specialty
• Marriage & Family Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.