DCCCA, INC (NPI# 1417280611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417280611 |
| Entity Type | Organization |
| Organization Name | DCCCA, INC |
| Other Organization Name | DCCCA MARKET ST MENTAL HEALTH |
| Practice Address |
700 N Market St Wichita KS 67214-3518 |
| Mailing Address |
3312 Clinton Pkwy Lawrence KS 66047-3624 |
| Practice Telephone | 3162657182 |
| Practice Fax Number | 3162653602 |
| Mailing Telephone | 7858414138 |
| Mailing Fax Number | 7858415777 |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | KERYE J JACKSON (CFO) |
| Authorized Official Telephone | 7858414138 |
| Authorized Official Credential | CPA, CMA |
| Is Organization Subpart | Y |
| Parent Organization Name | DCCCA, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | KS | Agencies | |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DCCCA Market St Mental Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558632299 | Dccca, Inc | Case Management | 3517 Lake Rd, Ponca City, OK 74604-5168 | 2012-01-25 |
| 1336329911 | Dccca, Inc | Clinic/Center | 2110 Kansas Ave, Great Bend, KS 67530-2516 | 2007-11-12 |
| 1932228533 | Dccca, Inc | Clinic/Center | 1319 W May St, Suite 1319b, Wichita, KS 67213-3505 | 2007-03-28 |
| 1609994359 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 1410 N Vine St, Hoisington, KS 67544-1557 | 2007-03-27 |
| 1356469209 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 3015 W 31st St, Lawrence, KS 66047-3042 | 2007-03-27 |
| 1215055090 | Dccca, Inc | Clinic/Center | 501 W Central St, Columbus, KS 66725-9211 | 2007-03-27 |
| 1932227683 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 2930 Sw Wanamaker Dr, Topeka, KS 66614-4116 | 2007-03-27 |
| 1477646073 | Dccca, Inc | Case Management | 501 S. Ninnescah, Pratt, KS 67124-2838 | 2006-10-02 |
| 1861793556 | Dccca, Inc | Case Management | 1102 S Rouse St, Pittsburg, KS 66762-6048 | 2010-11-11 |
| 1053551663 | Dccca, Inc | Case Management | 121 College St, Winfield, KS 67156-2442 | 2009-02-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DCCCA, INC. | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 |
| Colorado Business Entities | DCCCA, INC. | 3312 Clinton Pkwy, Lawrence, KS 66047 |
| Oklahoma Business Registrations | DCCCA, INC. | 3312 Clinton Parkway, Lawrence, KS 66047 |
| Street Address |
700 N MARKET ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67214-3518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073002283 | Danielle L Roberts | Marriage & Family Therapist | 700 N Market St, Wichita, KS 67214-3529 | 2018-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
| 1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
| 1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
| 1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
| 1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
| 1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
| 1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
| 1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
| Find all providers in zip 67214 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619441680 | Jkc Psych LLC | Clinic/Center | 8100 E 22nd St N Ste 1600, Wichita, KS 67226-2388 | 2019-01-14 |
| 1538642509 | Restoration Family Counseling Services | Clinic/Center | 5120 E Central Ave Ste 1, Wichita, KS 67208-4168 | 2018-09-14 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1932228533 | Dccca, Inc | Clinic/Center | 1319 W May St, Suite 1319b, Wichita, KS 67213-3505 | 2007-03-28 |
| 1609485804 | Therapeutic Paradigm | Clinic/Center | 7570 W 21st St N Ste 1006c, Wichita, KS 67205-1773 | 2020-07-24 |
| 1659997682 | Nuevo Amanecer LLC | Clinic/Center | 2312 S Meridian Ave Ste 102, Wichita, KS 67213-1912 | 2020-06-25 |
| 1447872718 | Kristi Mcneal LLC | Clinic/Center | 3310 E Douglas Ave, Wichita, KS 67208-3314 | 2020-05-10 |
| 1376163691 | Brent Crane Md LLC | Clinic/Center | 1148 S Hillside St, Wichita, KS 67211-4006 | 2020-04-17 |
| 1134758683 | Midwest Psychiatric Services, LLC | Clinic/Center | 3334 N Grey Meadow Ct, Wichita, KS 67205-8716 | 2020-04-06 |
| 1639714769 | Progressive Growth Counseling & Coaching, LLC | Clinic/Center | 1028 E 1st St N, Wichita, KS 67214-3903 | 2019-11-13 |
| 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.