IndividualActive
Bruce Nystrom, PHD
NPI 1700983368 · Clinical Psychologist · Wichita, KS
Provider details
- NPI number
- 1700983368
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 610 (KS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Clinical Child & Adolescent Psychologist103TC2200X
Practice location
4013 N Ridge Rd Ste 110
Wichita, KS 67205-8859
Phone: (316) 616-0260
Fax: (316) 616-0264
Approximate (ZIP-level) locationGet directions
Mailing address
727 N Waco Ave Ste 320
Wichita, KS 67203-3972
Registry dates
- Enumerated
- 2006-09-17
- Last updated
- 2022-08-30
- Certified
- 2022-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.