Lauren Carrillo, LCMFT

Individual provider Active NPI Marriage & Family Therapist · Wichita, KS

NPI 1962819110 · NPPES record last updated Aug 28, 2018

Key facts

NPI
1962819110
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
111 S Whittier St Ste 1500
Wichita, KS 67207
Phone
(316) 512-7520
Fax
(888) 974-1205
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X KS Yes

Addresses

Primary practice location

111 S Whittier St Ste 1500
Wichita, KS 67207

Mailing address

111 S Whittier St Ste 1500
Wichita, KS 67207-1045
Phone (316) 512-7520

Other practice location 1

12828 E 13th St N
Wichita, KS 67230-1465
Phone (316) 512-7520

Other providers in Wichita, KS

All providers in Wichita, KS · Marriage & Family Therapist in Kansas

Sources for this page

Verify at the official NPI Registry.