Provider Demographics
NPI:1770851180
Name:SEWELL, EMILY SUZANNE (MA, MS, PLMFT, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:MA, MS, PLMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9341 W 194TH TER
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:KS
Mailing Address - Zip Code:66013-9677
Mailing Address - Country:US
Mailing Address - Phone:816-863-5878
Mailing Address - Fax:
Practice Address - Street 1:12710 S PFLUMM RD
Practice Address - Street 2:SUITE 204
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3882
Practice Address - Country:US
Practice Address - Phone:816-863-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011039792106H00000X
KS2375106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist