Oleg Viktor Mironchenko, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5382879021 Issued in KS

Practice address

3320 Peterson Rd Ste 104
Lawrence, KS 66049-1739

Phone

(785) 371-1414

Fax

(785) 371-4519

NPI assigned

Feb 13, 2025

Last updated

Nov 3, 2025By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Psychological Services LLC

  • Psychologist
  • Lawrence, KS
  • NPI 1245517671
  NPD

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1538964705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 PETERSON RD STE 104",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660491739",
            "telephone_number": "785-371-1414",
            "fax_number": "785-371-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 PETERSON RD STE 104",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660491739",
            "telephone_number": "785-371-1414",
            "fax_number": "785-371-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRONCHENKO",
        "first_name": "OLEG",
        "middle_name": "VIKTOR",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "5382879021",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2024016173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Rae Miller, LCPC
• William Aaron Miller, D.C.
• Jonathan Mills
• Mind & Body Healing Collective, LLC
• Sara Minges, LPC
• Larissa Noel Mitchell, DPT
• Heidi E Mizer, PHARM.D.
• Modrell Clinical Services LLC (Fireside Counseling)
• Jessica Modrell, PSYD
• Erica Jean Molde, LSCSW

• Psychiatric/Mental Health Nurse Practitioner in Lawrence, KS
• Providers in Lawrence, KS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.