PROFESSIONAL RENEWAL CENTER PA (NPI# 1629220389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629220389 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL RENEWAL CENTER PA |
| Practice Address |
1201 Wakarusa Dr Suite E200 Lawrence KS 66049-4722 |
| Practice Telephone | 7858429772 |
| Practice Fax Number | 7858425231 |
| Mailing Telephone | 7858429772 |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |
| Authorized Official Name | DR. BETSY WILLIAMS (CLINICAL DIRECTOR, OWNER) |
| Authorized Official Telephone | 7858429772 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
KS | Behavioral Health & Social Service Providers |
| Street Address |
1201 WAKARUSA DR SUITE E200 |
| City | LAWRENCE |
| State | KS |
| Zip Code | 66049-4722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124013065 | Rhonda A Roy | Nurse Practitioner | 1201 Wakarusa Dr, Suite E2, Lawrence, KS 66049-4722 | 2005-09-16 |
| 1366932782 | Kristin Teasdale Phd LLC | Community/Behavioral Health | 1201 Wakarusa Dr, E2, Suite 102, Lawrence, KS 66049 | 2018-05-10 |
| 1518400043 | Ambika Selvan | Physical Therapy Assistant | 1201 Wakarusa Dr, Suite E-1, Lawrence, KS 66049-4722 | 2016-12-01 |
| 1376910471 | Regain Professional Services | Obstetrics & Gynecology | 1201 Wakarusa Dr, Suite A3, Lawrence, KS 66049-4722 | 2015-08-25 |
| 1851722052 | Natural Hormone Clinic Kansas LLC | Obstetrics & Gynecology | 1201 Wakarusa Dr, Suite A3, Lawrence, KS 66049-4722 | 2013-12-12 |
| 1013287911 | Mikell Adams Dc, Pa | Chiropractor | 1201 Wakarusa Dr, Ste A1, Lawrence, KS 66049-4722 | 2012-01-09 |
| 1477713832 | Mandle Ozbun Professional Development, LLC | Social Worker | 1201 Wakarusa Dr, Suite E2, Lawrence, KS 66049-4722 | 2008-06-10 |
| 1376643551 | Vickie S Hull | Marriage & Family Therapist | 1201 Wakarusa Dr, Suite E2, #103, Lawrence, KS 66049-4722 | 2006-09-25 |
| 1821194978 | Advanced Specialty Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1201 Wakarusa Dr, Bldg A Suite 3, Lawrence, KS 66049-4722 | 2006-09-16 |
| 1891715579 | Mikell Adams | Chiropractor | 1201 Wakarusa Dr, Ste A1, Lawrence, KS 66049-4722 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724481 | Mt Oread Pharmacy LLC | Pharmacy | 6265 Rock Chalk Drive, Lmh Health West, Suite 1401, Lawrence, KS 66049 | 2020-06-10 |
| 1497382204 | Limestone Eye Care LLC | Optometrist | 4320 W 6th Street, Suite 103, Lawrence, KS 66049 | 2020-03-24 |
| 1053840405 | Garrett Greaves | Physical Therapist | 100 Rock Chalk Lane, Suite 100, Lawrence, KS 66049 | 2017-06-08 |
| 1164971875 | Nicholas Salava | Dentist | 5100 Bob Billings Pkwy Ste 110, Lawrence, KS 66049 | 2016-09-23 |
| 1992163273 | Katherine Kershner | Physical Therapy Assistant | 11311 Wakarusa Dr Ste 1000, Lawrence, KS 66049 | 2016-02-02 |
| 1740670603 | Mary Cabib Tawadros | Family Medicine | 5911 Longleaf Dr., Lawrence, KS 66049 | 2015-01-30 |
| 1972872943 | Jean Alan Sanders | Pathology | 2820 Tomahawk Drive, Lawrence, KS 66049 | 2011-12-21 |
| 1881975563 | Vicki Annette Condra-williams | Counselor | 1123 Stone Meadows Drive, Lawrence, KS 66049 | 2011-09-08 |
| 1225328768 | Mark W Smith | Counselor | 2619 W. 6th St, Suite C, Lawrence, KS 66049 | 2011-04-18 |
| 1164739173 | Laura Elizabeth Reischman | Physical Therapy Assistant | 1305 Wakarusa Drive, Lawrence, KS 66049 | 2010-09-13 |
| Find all providers in zip 66049 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699899674 | Omar Gabriel Gudino | Psychologist | 832 Pennsylvania St Ste 17, Lawrence, KS 66044-2754 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841420353 | Tim R. Hodges | Psychologist | 519 Grove Street, Baldwin City, KS 66006-0065 | 2009-07-17 |
| 1669662698 | Amy Margaret Jacobsen | Psychologist | 8400 W. 110th Street, Suite 610, Overland Park, KS 66210 | 2007-07-26 |
| 1558570705 | Lisa R Hale | Psychologist | 10555 Marty St, Ste 100, Overland Park, KS 66212-2555 | 2007-05-22 |
| 1548384555 | Nancy Jeanne Champlin | Psychologist | 11302 Strang Line Rd, Lenexa, KS 66215-4041 | 2007-03-16 |
| 1598898231 | Karen J Wakefield | Psychologist | 2649 Sw Arrowhead Rd, Topeka, KS 66614-2458 | 2007-03-13 |
| 1770621674 | Integrated Behavioral Technologies Inc | Psychologist | 1106 N 155th St Ste B, Basehor, KS 66007-7100 | 2007-02-02 |
| 1639285398 | Jennifer Lynn Blickenstaff | Psychologist | 310 W Central Ave, Suite H, Andover, KS 67002-9687 | 2006-08-22 |
| 1700821279 | Priscilla None Wallingford | Psychologist | 13140 El Monte St, Leawood, KS 66209-4159 | 2006-06-18 |
| 1245278134 | Firststarr Rehabilitation & Behavioral Health, LLC | Psychologist | 4402 E Central Ave, Wichita, KS 67208-3912 | 2006-06-03 |
| 1023072436 | John Leenay | Psychologist | 727 N Waco Ave Ste 210, Wichita, KS 67203-3953 | 2006-04-13 |
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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.