Basic Information
| Provider Information | |||||||||
| NPI: | 1851813968 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUKU | ||||||||
| FirstName: | GODSWILL | ||||||||
| MiddleName: | OKORAFOR | ||||||||
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| Credential: | LMAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 509 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674012353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
| FaxNumber: | 7858252502 | ||||||||
| Practice Location | |||||||||
| Address1: | 1121 N 5TH ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661012305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138312820 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2017 | ||||||||
| LastUpdateDate: | 04/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 435 | KS | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 103TC1900X | 2877 | KS | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.