Provider Demographics
NPI:1316327190
Name:WINFIELD FAMILY THERAPY, LLC
Entity type:Organization
Organization Name:WINFIELD FAMILY THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-719-8229
Mailing Address - Street 1:104 1/2 W 9TH AVE
Mailing Address - Street 2:SUITE 432
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-2853
Mailing Address - Country:US
Mailing Address - Phone:620-719-8229
Mailing Address - Fax:620-229-8124
Practice Address - Street 1:104 1/2 W 9TH AVE
Practice Address - Street 2:SUITE 432
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2853
Practice Address - Country:US
Practice Address - Phone:620-719-8229
Practice Address - Fax:620-229-8124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty