Provider Demographics
NPI:1013585512
Name:FREYER-ROSE, KAY E (RN, CRAADC, LPC)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:E
Last Name:FREYER-ROSE
Suffix:
Gender:F
Credentials:RN, CRAADC, LPC
Other - Prefix:MS
Other - First Name:KAY
Other - Middle Name:E
Other - Last Name:FREYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:101 E GREGORY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1119
Mailing Address - Country:US
Mailing Address - Phone:816-806-7760
Mailing Address - Fax:
Practice Address - Street 1:101 E GREGORY BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1119
Practice Address - Country:US
Practice Address - Phone:816-806-7760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001294101Y00000X, 101YM0800X, 101YP2500X
MO871101YA0400X
MO097768163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
20253013OtherBLUE CROSS BLUE SHIELD