Provider Demographics
NPI:1992423479
Name:RICE, CRYSTIN (LCMFT)
Entity type:Individual
Prefix:
First Name:CRYSTIN
Middle Name:
Last Name:RICE
Suffix:
Gender:
Credentials:LCMFT
Other - Prefix:
Other - First Name:CRYSTIN
Other - Middle Name:
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMFT
Mailing Address - Street 1:111 S WHITTIER RD STE 4000C
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-1045
Mailing Address - Country:US
Mailing Address - Phone:316-689-4207
Mailing Address - Fax:316-536-4188
Practice Address - Street 1:111 S WHITTIER RD STE 4000C
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1045
Practice Address - Country:US
Practice Address - Phone:316-689-4207
Practice Address - Fax:316-536-4188
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03387106H00000X, 106H00000X
KS03442106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist