NPI 1790190791 · live from the CMS NPI Registry
Susanna Ciccolari Micaldi, MD
Psychiatry & Neurology, Child & Adolescent Psychiatry in Wichita, KS. National Provider Identifier 1790190791, active.
NPI record
| NPI | 1790190791 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Child & Adolescent Psychiatry 2084P0804X |
| Practice location | 1001 N. Minneapolis St, Wichita, KS 67214 |
| Practice phone | 316-293-2647 |
| Mailing address | 1001 N Minneapolis St, Wichita, KS 67214 |
| Enumerated | June 27, 2014 |
| Last updated | June 21, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Psychiatry | 2084P0800X | 94-08402 (KS) |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | 04-41077 (KS) |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | 2084P0804X | 94-08402 (KS) |
| Psychiatry & Neurology, Child & Adolescent Psychiatry primary | 2084P0804X | 04-41077 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.