Provider Demographics
NPI:1376102665
Name:PARRY, KENEDEE MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KENEDEE
Middle Name:MARIE
Last Name:PARRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KENEDEE
Other - Middle Name:MARIE
Other - Last Name:GRIEVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4701 COLLEGE BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1608
Mailing Address - Country:US
Mailing Address - Phone:913-777-4020
Mailing Address - Fax:
Practice Address - Street 1:4701 COLLEGE BLVD STE 115
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1608
Practice Address - Country:US
Practice Address - Phone:913-777-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1396085718Medicaid