Provider Demographics
NPI:1740266881
Name:HYKEN-LANDE, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HYKEN-LANDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9905 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5417
Mailing Address - Country:US
Mailing Address - Phone:816-519-9817
Mailing Address - Fax:913-541-9494
Practice Address - Street 1:4149 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3087
Practice Address - Country:US
Practice Address - Phone:816-531-6030
Practice Address - Fax:913-648-4799
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0055971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical