Provider Demographics
NPI:1073020996
Name:KATE SIRRIDGE, PH.D. LLC
Entity Type:Organization
Organization Name:KATE SIRRIDGE, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:MCLEAN
Authorized Official - Last Name:SIRRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:913-579-6410
Mailing Address - Street 1:9229 WARD PKWY STE 225
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3311
Mailing Address - Country:US
Mailing Address - Phone:816-444-5511
Mailing Address - Fax:816-822-8058
Practice Address - Street 1:9229 WARD PKWY STE 225
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3311
Practice Address - Country:US
Practice Address - Phone:816-444-5511
Practice Address - Fax:816-822-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-30
Last Update Date:2017-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015007530103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty