Provider Demographics
NPI:1568433886
Name:LEMON, KATHLEEN F (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:F
Last Name:LEMON
Suffix:
Gender:F
Credentials:PSYD
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Other - Credentials:
Mailing Address - Street 1:1531 E BRADFORD PKWY
Mailing Address - Street 2:STE 210-1
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6856
Mailing Address - Country:US
Mailing Address - Phone:417-430-5780
Mailing Address - Fax:417-823-9202
Practice Address - Street 1:1531 E BRADFORD PKWY
Practice Address - Street 2:STE 210-1
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6856
Practice Address - Country:US
Practice Address - Phone:417-430-5780
Practice Address - Fax:417-823-9202
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO01526103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO498203702Medicaid
MO498203702Medicaid