Wisdom, Robert

Wisdom, Robert is an individual health care provider with primary practice located at 1558 Hayes Dr , Manhattan KS 66502-5068. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Wisdom, Robert can be contacted via phone (785) 587-4315.

Contact Information

Primary practice address
1558 Hayes Dr Manhattan KS 66502-5068
Phone: (785) 587-4315
Fax: (785) 587-4339
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0157 Kansas
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 130 Kansas
Behavioral Health & Social Service Providers / Professional 101YP2500X 1438 Kansas

Profile Details

NPI number 1063456721
LBN Legal business name Wisdom, Robert
Credentials LMLP, LCP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Jan 24th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063456721 NPPES
Kansas Other 856662 BCBS
Kansas Other 11654652 BCBS
Kansas MEDICAID 200441350A BCBS

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