Provider Demographics
NPI:1023178563
Name:MCCLUNIE, VONETTA
Entity Type:Individual
Prefix:
First Name:VONETTA
Middle Name:
Last Name:MCCLUNIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 MCGEE ST
Mailing Address - Street 2:ROOM 905-C
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-2416
Mailing Address - Country:US
Mailing Address - Phone:816-418-7840
Mailing Address - Fax:816-418-1805
Practice Address - Street 1:801 N MUR LEN RD STE 111
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1794
Practice Address - Country:US
Practice Address - Phone:913-393-4283
Practice Address - Fax:913-393-4969
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004755174400000X
KS2776106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174400000XOther Service ProvidersSpecialist