Provider Demographics
NPI:1467916353
Name:O'BLENESS, CYNDIE (LMAC)
Entity Type:Individual
Prefix:
First Name:CYNDIE
Middle Name:
Last Name:O'BLENESS
Suffix:
Gender:F
Credentials:LMAC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:EUTSLER
Other - Last Name:O'BLENESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10312 NW RIVER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3439
Mailing Address - Country:US
Mailing Address - Phone:816-888-0432
Mailing Address - Fax:
Practice Address - Street 1:10100 W 87TH ST STE M
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-4628
Practice Address - Country:US
Practice Address - Phone:816-888-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS372101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)