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FAMILY THERAPY INSTITUTE MIDWEST NPI 1306872064


NPI Information

NPI: 1306872064
Provider Name: FAMILY THERAPY INSTITUTE MIDWEST
Classification: Psychologist - 103TC2200X
Entity Type: Organization

Specialization: Clinical Child & Adolescent

Address:
2619 W. 6TH STREET, SUITE C
LAWRENCE, KS
ZIP 66049
Phone: (785) 830-8299
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FAMILY THERAPY INSTITUTE MIDWEST is a clinical child and adolescent psychologist in Lawrence, KS. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. FAMILY THERAPY INSTITUTE MIDWEST NPI is 1306872064. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2619 W. 6TH STREET, SUITE C
LAWRENCE, KS
ZIP 66049
Phone: (785) 830-8299
Fax: (785) 749-2581

The provider's authorized official is Mary Lu Egidy .
The authorized official title is Owner and has the following contact phone number (785) 830-8299.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 11/7/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1104100000XSocial Worker6890KANSASNo
2163WP0807XRegistered NursePsychiatric/Mental Health, Child & Adolescent46111KANSASNo
3103TC2200XPsychologistClinical Child & Adolescent1109KANSASNo
41041C0700XSocial WorkerClinical1740KANSASNo
51041C0700XSocial WorkerClinical3569KANSASNo
6163WP0807XRegistered NursePsychiatric/Mental Health, Child & Adolescent74564KANSASNo
7103TC2200XPsychologistClinical Child & Adolescent0894KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100297790CMEDICAIDKANSAS
2100389740AMEDICAIDKANSAS
3100353150AMEDICAIDKANSAS
4100353230AMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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