Provider Demographics
NPI:1447686126
Name:FAUST, MARCIE D (LPC, NBCC)
Entity type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:D
Last Name:FAUST
Suffix:
Gender:F
Credentials:LPC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MYLES CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-7803
Mailing Address - Country:US
Mailing Address - Phone:316-304-7991
Mailing Address - Fax:316-733-3648
Practice Address - Street 1:1015 MYLES CT
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-7803
Practice Address - Country:US
Practice Address - Phone:316-304-7991
Practice Address - Fax:316-733-3648
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2510101Y00000X, 101YP2500X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS12599684OtherBLUE CROSS BLUE SHIELD