Provider Demographics
NPI:1699842724
Name:HINTZ, KOREEN D (LCPC)
Entity Type:Individual
Prefix:
First Name:KOREEN
Middle Name:D
Last Name:HINTZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KORI
Other - Middle Name:D
Other - Last Name:HINTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:11695 S BLACK BOB RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062
Mailing Address - Country:US
Mailing Address - Phone:913-768-6606
Mailing Address - Fax:913-768-6609
Practice Address - Street 1:11695 S BLACKBOB RD
Practice Address - Street 2:SUITE B
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1020
Practice Address - Country:US
Practice Address - Phone:913-768-6606
Practice Address - Fax:913-768-6609
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC 266101YM0800X
KSPSY D 1356103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist