Provider Demographics
NPI:1730580614
Name:COUNSELING ASSOCIATES OF THE FLINT HILLS
Entity type:Organization
Organization Name:COUNSELING ASSOCIATES OF THE FLINT HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:MULRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-564-0865
Mailing Address - Street 1:221 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL GROVE
Mailing Address - State:KS
Mailing Address - Zip Code:66846-1704
Mailing Address - Country:US
Mailing Address - Phone:785-709-0532
Mailing Address - Fax:785-482-3266
Practice Address - Street 1:221 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COUNCIL GROVE
Practice Address - State:KS
Practice Address - Zip Code:66846-1704
Practice Address - Country:US
Practice Address - Phone:785-709-0532
Practice Address - Fax:785-482-3266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100007820DMedicaid
KS100007820DMedicaid