Active NPI
Stacie Watts, MS, LCMFT
- Marriage & Family Therapist
- Wichita, KS
National Provider Identifier
1750630760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LCMFT 753
- Practice address
- 520 S Holland St
Suite 401
Wichita, KS 67209-2096 - Phone
- (316) 729-9965
- NPI assigned
- Sep 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LCMFT 753 | KS | Primary |
Addresses
Primary practice location
520 S Holland St
Suite 401
Wichita, KS 67209-2096
Mailing address
520 S Holland St
Ste 401
Wichita, KS 67209-2096
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCMFT 753 | KS | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeanette Diederich | Past | Accepting new patients | |
| Earnestine Lamonica Williams | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Wichita, KS
- NPI 1104104504
-
- Clinical Social Worker
- Wichita, KS
- NPI 1376813246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352160000000",
"number": "1750630760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S HOLLAND ST",
"address_2": "STE 401",
"city": "WICHITA",
"state": "KS",
"postal_code": "672092096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S HOLLAND ST",
"address_2": "SUITE 401",
"city": "WICHITA",
"state": "KS",
"postal_code": "672092096",
"telephone_number": "316-729-9965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "STACIE",
"credential": "MS, LCMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-05",
"last_updated": "2012-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KS",
"license": "LCMFT 753",
"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 Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.