Provider Demographics
NPI:1124464060
Name:SUMMERS, SUSAN G (LCPC, LCAC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:LCPC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N WOODLAWN BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-3956
Mailing Address - Country:US
Mailing Address - Phone:316-206-1127
Mailing Address - Fax:316-206-1137
Practice Address - Street 1:NEW PERSPECTIVES LLC
Practice Address - Street 2:8623 E. 23ND ST NORTH
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226
Practice Address - Country:US
Practice Address - Phone:316-869-2888
Practice Address - Fax:316-425-5550
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS256101YA0400X
KS2870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201121930AMedicaid