Awaken Psychology LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2476 Issued in KS

Legal business name

AWAKEN PSYCHOLOGY LLC

Practice address

2552 N Maize CT Suite 600
Wichita, KS 67205

Phone

(316) 202-9492

Fax

(316) 202-9496

NPI assigned

Sep 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Brynne Mulloy, PSYDNPI 1700135498

Title

Owner, Director

Phone

(316) 202-9492

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Brynne M Mulloy, PSY.D.

  • Clinical Psychologist
  • Wichita, KS
  • NPI 1700135498
  NPD (past) Authorized official

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811415466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 N MAIZE CT SUITE 600",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-202-9492",
            "fax_number": "316-202-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 N MAIZE CT SUITE 600",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-202-9492",
            "fax_number": "316-202-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MULLOY",
        "authorized_official_first_name": "BRYNNE",
        "authorized_official_title_or_position": "OWNER, DIRECTOR",
        "authorized_official_telephone_number": "316-202-9492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "KS",
            "license": "2476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700135498",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Wichita, KS
• Providers in Wichita, KS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.