Provider Demographics
NPI:1275639445
Name:GINGERICH, KAREN EILEEN (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EILEEN
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 BROOKSIDE PLZ STE 290
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-1709
Mailing Address - Country:US
Mailing Address - Phone:816-304-1646
Mailing Address - Fax:
Practice Address - Street 1:9200 INDIAN CREEK PKWY STE 660
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2097
Practice Address - Country:US
Practice Address - Phone:816-522-3566
Practice Address - Fax:913-772-8580
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002011109103T00000X
KS1274103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS119896OtherKANSAS BCBS
KS004517OtherKANSAS BCBS GROUP
KS36348021OtherKC BCBS
KS36348021OtherKC BCBS