Individual provider Active NPI

Maria Lauralynn Noblejas, PSYD., LP

  • Clinical Psychologist
  • Liberal, KS
National Provider Identifier
1851498513
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1316 Issued in KS
Practice address
10 Plaza Dr
Liberal, KS 67901-2743
Phone
(620) 417-5230
Fax
(620) 624-5227
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1316 KS Primary

Addresses

Primary practice location

10 Plaza Dr
Liberal, KS 67901-2743

Mailing address

10 Plaza Dr
Liberal, KS 67901-2743
Phone (620) 417-5230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000521 KS Practitioner - Clinical Psychologist 2062441306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Plaza Dr
Liberal, KS 67901-2743
Phone (620) 417-5230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1316KSMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Guidance Center Past Accepting new patients
Southwest Guidance Center Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southwest Medical CenterLiberal, KS, CCN 170068 Hospital Corporate Director Apr 1, 2021
Southwest Medical CenterLiberal, KS, CCN 175163 Skilled nursing facility Corporate Director Jul 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1851498513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PLAZA DR",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012743",
            "telephone_number": "620-417-5230",
            "fax_number": "620-624-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PLAZA DR",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012743",
            "telephone_number": "620-417-5230",
            "fax_number": "620-624-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLEJAS",
        "first_name": "MARIA",
        "middle_name": "LAURALYNN",
        "name_prefix": "Dr.",
        "credential": "PSYD., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberal, KS

Sources for this page

Verify at the official NPI Registry.