Individual provider Active NPI

Cheyenne Lara, LPC

  • Professional Counselor
  • Wichita, KS
National Provider Identifier
1619715059
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC04762 Issued in KS
Practice address
345 N Riverview St Ste 730
Wichita, KS 67203-4267
Phone
(316) 202-2110
NPI assigned
Jul 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC04762 KS Primary

Addresses

Primary practice location

345 N Riverview St Ste 730
Wichita, KS 67203-4267

Mailing address

2510 S Cypress St
Wichita, KS 67210-2463
Phone (316) 833-2949

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240813000578 KS Practitioner - Mental Health Counselor 2264970938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC04762KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Level LLC Professional CurrentSince Aug 1, 2024 Accepting new patients

Locations

2955 SW Wanamaker Dr
Ste B
Topeka, KS 66614
Phone (785) 221-2755

345 N Riverview St
Ste 730
Wichita, KS 67203
Phone (316) 202-2110

9415 E Harry St
Ste 306
Wichita, KS 67207
Phone (316) 202-2110

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1619715059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 S CYPRESS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672102463",
            "telephone_number": "316-833-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N RIVERVIEW ST STE 730",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034267",
            "telephone_number": "316-202-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "CHEYENNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "LPC04762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.