Provider Demographics
NPI:1346871142
Name:AHLSTEDT, SUSAN (MFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:AHLSTEDT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9117 GRANT LN
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4830
Mailing Address - Country:US
Mailing Address - Phone:913-226-4837
Mailing Address - Fax:
Practice Address - Street 1:8826 SANTA FE DR STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3672
Practice Address - Country:US
Practice Address - Phone:913-210-0590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist