Autumn Taya Pourhussin, MS, LMLP-T
Psychologist, Counseling in Wichita, KS. Individual provider (NPI-1).
NPI number1194535781
StatusActive
Last updated in NPPESMar 7, 2025
Details
- NPI
- 1194535781
- Entity type
- Individual (NPI-1)
- Name
- Autumn Taya Pourhussin
- Credential
- MS, LMLP-T
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 7, 2025
- Certification date
- Mar 7, 2025
- Last updated
- Mar 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | 03386 | KS | Yes |
| 103TC0700X | Psychologist, Clinical | 03337-T | KS |
Practice location
8100 E 22nd St N Ste 100Wichita, KS 67226-2350
Phone 316-201-6047
Mailing address
1837 Drollinger StWichita, KS 67218-4705
Phone 316-393-8792
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