MS. ALICIA ROSE LANDRUM (NPI# 1154877603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154877603 |
| Entity Type | Individual |
| Full Name | MS. ALICIA ROSE LANDRUM |
| Credential | LCPC, LMAC |
| Practice Address |
515 N Ridge Rd Ste 105 Wichita KS 67212 |
| Mailing Address |
515 N Ridge Rd Ste 105 Wichita KS 67212-6389 |
| Practice Telephone | 3163477171 |
| Practice Fax Number | 3164620920 |
| Mailing Telephone | 3163477171 |
| Mailing Fax Number | 3164620920 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2019-04-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
073 | KS | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2700 | KS | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
2985 | KS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 201143180A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1920 16th St Ste 105, Great Bend, KS 675304036 | 6202820912 | 3164620920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245454347 | Alicia Landrum | Counselor | 1719 Merrill Dr, Little Rock, AR 72212-4009 | 2007-04-12 |
| Street Address |
515 N RIDGE RD STE 105 |
| City | WICHITA |
| State | KS |
| Zip Code | 67212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396974 | Kim Deann Kercher | Physical Therapist | Legacy At Grassland Estates, 10665 W 13th St N Apt 329, Wichita, KS 67212 | 2020-11-04 |
| 1700370954 | Andrea Lou Wheeler | Registered Nurse | 658 N Fairway Ave, Wichita, KS 67212 | 2018-06-20 |
| 1568981231 | Wichita Family Dental LLC | Dentist | 1445 N. Ridge Rd, Wichtia, KS 67212 | 2017-09-14 |
| 1396260121 | Keegan Hemberger | Pharmacist | 555 N. Maize Road, Wichita, KS 67212 | 2017-08-14 |
| 1306218920 | Brandee Young | Occupational Therapist | 9710 W. Jamesburg, Wichita, KS 67212 | 2015-10-22 |
| 1588072201 | Michelle Kuhn | Pharmacist | 10515 W Central, Wichita, KS 67212 | 2014-07-25 |
| 1972914083 | Linda Mueller Mueller | Marriage & Family Therapist | 4425 West Zoo Blvd, Wichita, KS 67212 | 2014-05-12 |
| 1619392305 | Jessica Smith | Counselor | 1319 W May, Wichita, KS 67212 | 2014-03-04 |
| 1245652064 | Keepsake Kottage, LLC | Custodial Care Facility | 8801 W Bekemeyer, Wichita, KS 67212 | 2014-01-14 |
| 1568702462 | Kansas Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 10405 West 13th St, Wichita, KS 67212 | 2013-03-01 |
| Find all providers in zip 67212 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393179 | Mendy Logan | Counselor | 1999 N Amidon Ave Ste 373, Wichita, KS 67203-2154 | 2020-10-09 |
| 1043850803 | Evelyn Wright | Counselor | 1034 S Burrus St, Wichita, KS 67207-3623 | 2020-01-09 |
| 1356982516 | Dynamic Counseling Services LLC | Counselor | 572 S Oliver St, Wichita, KS 67218-2351 | 2019-09-30 |
| 1376001677 | Holly Lynn Paine | Counselor | 3446 S Ida St, Wichita, KS 67216-1558 | 2019-03-05 |
| 1043712912 | Creative Bliss Therapy | Counselor | 115 Waterman Street, Wichita, KS 67202 | 2018-03-06 |
| 1467960898 | Chelsey Johnson Thornhill | Counselor | 4601 E Douglas Ave Ste 209, Wichita, KS 67218-1031 | 2018-01-19 |
| 1467986836 | Megan Elizabeth Couey | Counselor | 8623 E 32nd St. N, Suite 100, Wichita, KS 67226 | 2017-04-12 |
| 1922557511 | Tamell Jason-heitman | Counselor | 1333 N Broadway Ave Ste B, Wichita, KS 67214-2894 | 2016-09-24 |
| 1033663935 | Janelle Osborn | Counselor | 2205 N Parkridge Ct, Wichita, KS 67205-2004 | 2016-08-08 |
| 1396147096 | Heather Ann Shelton | Counselor | 1919 N Amidon Ave Ste 108, Wichita, KS 67203 | 2014-09-24 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.