Provider Demographics
NPI:1972055325
Name:AMEND NEUROCOUNSELING
Entity Type:Organization
Organization Name:AMEND NEUROCOUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:816-810-9046
Mailing Address - Street 1:8900 INDIAN CREEK PKWY
Mailing Address - Street 2:SUITE 270
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1554
Mailing Address - Country:US
Mailing Address - Phone:913-955-3250
Mailing Address - Fax:913-955-3259
Practice Address - Street 1:8900 INDIAN CREEK PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1554
Practice Address - Country:US
Practice Address - Phone:913-955-3250
Practice Address - Fax:913-955-3259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS755101YP2500X
KS840106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty