Provider Demographics
NPI:1568978039
Name:MEISINGER, PEYTON JEAN
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:JEAN
Last Name:MEISINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PEYTON
Other - Middle Name:JEAN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6394 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1506
Mailing Address - Country:US
Mailing Address - Phone:800-345-0448
Mailing Address - Fax:
Practice Address - Street 1:1460 NW VIVION RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4555
Practice Address - Country:US
Practice Address - Phone:816-853-0946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020013180103K00000X
106S00000X
KS376103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician