Provider Demographics
NPI:1568765329
Name:CODDINGTON, VALERIE S (PSYD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:S
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3149
Mailing Address - Country:US
Mailing Address - Phone:913-259-8829
Mailing Address - Fax:
Practice Address - Street 1:1301 N WAREHOUSE RD
Practice Address - Street 2:
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-2364
Practice Address - Country:US
Practice Address - Phone:913-758-3762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014040971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1568765329Medicaid