Kenneth Joseph Kooser, LMFT 03643-T

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

03796 Issued in KS

Practice address

1221 N Rock Rd
Derby, KS 67037-3678

Phone

(316) 789-8511

NPI assigned

Sep 20, 2024

Last updated

Oct 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sedgwick

  dba Sedgwick County Health Department

  • Public Health or Welfare Agency
  • Wichita, KS
  • NPI 1629281373
  NPD

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1831916048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 E WOODBROOK CT",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670379713",
            "telephone_number": "316-518-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N ROCK RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373678",
            "telephone_number": "316-789-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOSER",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "LMFT 03643-T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "03796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy S Kelley, BSN,AAPS
• Katy Kitterman
• Kristen Grace Macaraeg Knowles
• James A Koch, OT
• Cassity J Kolterman, PTA
• Shonda L Kooser, T-MFT 03519-T
• Heather Korntheuer, CPTA
• Hai Minh Koulaboud, PHARM D.
• Alexandra Krisik
• Chantel Lambert, OTR/L

• Marriage & Family Therapist in Derby, KS
• Providers in Derby, KS by specialty
• Marriage & Family Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.