Provider Demographics
NPI:1467243592
Name:LONEY, KAITLIN M (MA)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:M
Last Name:LONEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-2704
Mailing Address - Country:US
Mailing Address - Phone:316-648-0788
Mailing Address - Fax:
Practice Address - Street 1:2728 E CHESTNUT EXPY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-2555
Practice Address - Country:US
Practice Address - Phone:417-848-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor