Provider Demographics
NPI:1770596892
Name:EAVES, WENDY S (PHD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:S
Last Name:EAVES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 W 135TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-4849
Mailing Address - Country:US
Mailing Address - Phone:913-499-4302
Mailing Address - Fax:913-499-4304
Practice Address - Street 1:6240 W 135TH ST STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-4849
Practice Address - Country:US
Practice Address - Phone:913-499-4302
Practice Address - Fax:913-308-0880
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS 811103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS19320048OtherBLUE CROSS BLUE SHIELD
KSS987424Medicare ID - Type Unspecified