Provider Demographics
NPI:1235937863
Name:WICHITA MIND & WELLNESS LLC
Entity type:Organization
Organization Name:WICHITA MIND & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JURGENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:316-747-1578
Mailing Address - Street 1:4601 E DOUGLAS AVE STE 362
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1011
Mailing Address - Country:US
Mailing Address - Phone:316-747-1578
Mailing Address - Fax:
Practice Address - Street 1:1210 N LAWRENCE LN
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1451
Practice Address - Country:US
Practice Address - Phone:316-747-1578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty