Provider Demographics
NPI:1043999055
Name:EIKLEBERRY, MARIAH JAYDE (LPC-T, PLPC)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:JAYDE
Last Name:EIKLEBERRY
Suffix:
Gender:F
Credentials:LPC-T, PLPC
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:JAYDE
Other - Last Name:SIBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 NE RICE RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5849
Mailing Address - Country:US
Mailing Address - Phone:816-347-3069
Mailing Address - Fax:
Practice Address - Street 1:3211 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-2073
Practice Address - Country:US
Practice Address - Phone:816-966-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC04384-T101Y00000X
MO2023033875101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor