Provider Demographics
NPI:1306991419
Name:RICE, KRIS DELYNN (LICENSED CLINICAL SO)
Entity type:Individual
Prefix:MRS
First Name:KRIS
Middle Name:DELYNN
Last Name:RICE
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-3502
Mailing Address - Country:US
Mailing Address - Phone:785-772-5041
Mailing Address - Fax:785-332-2644
Practice Address - Street 1:112 E SPENCER ST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-3502
Practice Address - Country:US
Practice Address - Phone:785-772-5041
Practice Address - Fax:785-332-2644
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3841101YM0800X
CO1166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200688390BMedicaid