Individual provider Active NPI

Angela C Heckrotte, LCMFT, LAC

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1649603382
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2730 Issued in KS
Practice address
9415 E Harry St Ste 204
Wichita, KS 67207-5076
Phone
(316) 749-8550
NPI assigned
Aug 16, 2013
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1342 KS
Marriage & Family Therapist 106H00000X 2730 KS Primary

Addresses

Primary practice location

9415 E Harry St Ste 204
Wichita, KS 67207-5076

Mailing address

1143 N Geuda Springs Rd
Mulvane, KS 67110-8020
Phone (316) 290-9896

Other practice location 1

7807 E Funston St
Wichita, KS 67207-3123
Phone (316) 636-1188

Other identifiers 1

IdentifierTypeStateIssuer
201083610AMedicaidKS

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

LicenseStateTypeSpecialty
2730KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul L. Kurtzweil, PH.D. LLC CurrentSince Aug 28, 2021 Accepting new patients

Locations

7807 E Funston St
Wichita, KS 67207
Phone (316) 636-1188

9415 E Harry St
Ste 204
Wichita, KS 67207
Phone (316) 200-5391

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1649603382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 N GEUDA SPRINGS RD",
            "city": "MULVANE",
            "state": "KS",
            "postal_code": "671108020",
            "telephone_number": "316-290-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 E HARRY ST STE 204",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672075076",
            "telephone_number": "316-749-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7807 E Funston St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672073123",
            "country_code": "US",
            "telephone_number": "316-636-1188",
            "fax_number": "316-636-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HECKROTTE",
        "first_name": "ANGELA",
        "middle_name": "C",
        "credential": "LCMFT, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "1342",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201083610A",
            "state": "KS"
        }
    ],
    "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 Jul 16, 2021; 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.