Provider Demographics
NPI:1548943079
Name:CBW THERAPY LLC
Entity type:Organization
Organization Name:CBW THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:
Authorized Official - Last Name:WYCKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-414-9911
Mailing Address - Street 1:800 SW JACKSON ST
Mailing Address - Street 2:STE 618 #528
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612
Mailing Address - Country:US
Mailing Address - Phone:785-414-9911
Mailing Address - Fax:785-414-5228
Practice Address - Street 1:800 SW JACKSON ST
Practice Address - Street 2:STE 618 #528
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612
Practice Address - Country:US
Practice Address - Phone:785-414-9911
Practice Address - Fax:785-414-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty