Provider Demographics
NPI:1982649091
Name:WHEATLEY, MARCIE K (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:K
Last Name:WHEATLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13839 S MUR LEN RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1652
Mailing Address - Country:US
Mailing Address - Phone:913-764-5463
Mailing Address - Fax:913-764-4160
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:SUITE K
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-764-5463
Practice Address - Fax:913-764-4160
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist