Provider Demographics
NPI:1659864916
Name:WELLS, SUSAN KAY (LPC, NCC, LMAC)
Entity Type:Individual
Prefix:
First Name:SUSAN KAY
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:LPC, NCC, LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9821 FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2360
Mailing Address - Country:US
Mailing Address - Phone:913-271-5083
Mailing Address - Fax:
Practice Address - Street 1:3105 W 135TH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-7503
Practice Address - Country:US
Practice Address - Phone:913-271-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS406101YA0400X
KS3076101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)