NPIMap

Organization Active NPI

Southwest Guidance Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Liberal, KS
National Provider Identifier
1801991203
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTHWEST GUIDANCE CENTER
Practice address
333 W 15TH St
Liberal, KS 67901-2455
Phone
(620) 624-8171
Fax
(620) 624-0114
NPI assigned
Sep 13, 2006
Last updated
Dec 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Ms. Leslie D Bissell, LPNPI 1720030018
Title
Executive Director
Phone
(620) 624-8171

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

333 W 15TH St
Liberal, KS 67901-2455

Mailing address

PO Box 2945
Liberal, KS 67905-2945
Phone (620) 624-8171

Other identifiers 2

IdentifierTypeStateIssuer
100098060AMedicaidKS
100098060BMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000602 KS Part B Supplier - Clinic/Group Practice 7214834639 Receives reassigned benefits from 6 practitioners
Practice locations: Sublette, KS; Meade, KS; Hugoton, KS; Liberal, KS

National Provider Directory

National Provider Directory
Tax ID family
Southwest Guidance Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

333 W 15th St
Liberal, KS 67901
Phone (620) 624-8171

333 W 15th St
Ste 2945
Liberal, KS 67901
Phone (316) 624-8171

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1801991203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2945",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679052945",
            "telephone_number": "620-624-8171",
            "fax_number": "620-624-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 15TH ST",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012455",
            "telephone_number": "620-624-8171",
            "fax_number": "620-624-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GUIDANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "BISSELL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "620-624-8171",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098060A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098060B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberal, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.