Botkin, Matthew R

Botkin, Matthew R is an individual health care provider with primary practice located at 6440 Nieman Rd , Shawnee KS 66203-3326. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Botkin, Matthew R can be contacted via phone (913) 962-9955.

Contact Information

Primary practice address
6440 Nieman Rd Shawnee KS 66203-3326
Fax: (913) 826-1589
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 157 Kansas

Profile Details

NPI number 1003937764
LBN Legal business name Botkin, Matthew R
Credentials LCP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2007
Last updated May 11th, 2010 - about 16 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 1003937764 NPPES
Kansas MEDICAID 100098010B

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