Provider Demographics
NPI:1134888035
Name:PROCOPIO, SEBASTIANO (PHD)
Entity type:Individual
Prefix:
First Name:SEBASTIANO
Middle Name:
Last Name:PROCOPIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 METCALF AVE # 285
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1476
Mailing Address - Country:US
Mailing Address - Phone:913-346-5681
Mailing Address - Fax:
Practice Address - Street 1:9218 METCALF AVE # 285
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1476
Practice Address - Country:US
Practice Address - Phone:913-346-5681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2560103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling