Provider Demographics
NPI:1164296240
Name:BURNEY, DAYLEN OLIVER
Entity Type:Individual
Prefix:
First Name:DAYLEN
Middle Name:OLIVER
Last Name:BURNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2838
Mailing Address - Country:US
Mailing Address - Phone:918-406-1031
Mailing Address - Fax:
Practice Address - Street 1:600 NW MURRAY RD STE 110
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-1238
Practice Address - Country:US
Practice Address - Phone:816-272-5656
Practice Address - Fax:816-817-8820
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020302916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty