Provider Demographics
NPI:1275674988
Name:THOMAS, KATHRYN JOAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JOAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12409 OVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1425
Mailing Address - Country:US
Mailing Address - Phone:913-696-9886
Mailing Address - Fax:816-561-8199
Practice Address - Street 1:3914 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2925
Practice Address - Country:US
Practice Address - Phone:816-561-9494
Practice Address - Fax:816-561-8199
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005039242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional