Organization Active NPI

Chris Ebberwein PH.D., P.a.

  • Counseling Psychologist
  • Wichita, KS
National Provider Identifier
1659594653
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1136 Issued in KS
Legal business name
CHRIS EBBERWEIN PH.D., P.A.
Practice address
10222 W Central Ave Ste 202
Wichita, KS 67212-4613
Phone
(316) 773-9525
Fax
(316) 773-2012
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Dr. Christopher A Ebberwein, PH.D.NPI 1255443651
Title
Licensed Psychologist
Phone
(316) 773-9525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 1136 KS Primary

Addresses

Primary practice location

10222 W Central Ave Ste 202
Wichita, KS 67212-4613

Mailing address

10222 W Central Ave Ste 202
Wichita, KS 67212-4613
Phone (316) 773-9525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210804003062 KS Part B Supplier - Clinic/Group Practice 5597169144 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1659594653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10222 W CENTRAL AVE STE 202",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124613",
            "telephone_number": "316-773-9525",
            "fax_number": "316-773-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10222 W CENTRAL AVE STE 202",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124613",
            "telephone_number": "316-773-9525",
            "fax_number": "316-773-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS EBBERWEIN PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "EBBERWEIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "316-773-9525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "KS",
            "license": "1136",
            "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 Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.