Active NPI
Mary Ann Byerly
- Professional Counselor
- Wichita, KS
National Provider Identifier
1558091835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC04062
- Practice address
- 11828 W Central Ave Ste 104
Wichita, KS 67212-5178 - Phone
- (316) 613-3995
- Fax
- (833) 680-2402
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC04062 | KS | Primary |
Addresses
Primary practice location
11828 W Central Ave Ste 104
Wichita, KS 67212-5178
Mailing address
11828 W Central Ave Ste 104
Wichita, KS 67212-5178
Phone (316) 613-3995
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC04062 | KS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1558091835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11828 W CENTRAL AVE STE 104",
"city": "WICHITA",
"state": "KS",
"postal_code": "672125178",
"telephone_number": "316-613-3995",
"fax_number": "833-680-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11828 W CENTRAL AVE STE 104",
"city": "WICHITA",
"state": "KS",
"postal_code": "672125178",
"telephone_number": "316-613-3995",
"fax_number": "833-680-2402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYERLY",
"first_name": "MARY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "LPC04062",
"primary": true
}
],
"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 Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.