MRS. JENNIFER LYNN BLICKENSTAFF (NPI# 1639285398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639285398 |
Entity Type | Individual |
Full Name | MRS. JENNIFER LYNN BLICKENSTAFF |
Credential | LCP |
Practice Address |
310 W Central Ave Suite H Andover KS 67002-9687 |
Practice Telephone | 3167339469 |
Practice Fax Number | 3167338421 |
Mailing Telephone | 3167339469 |
Mailing Fax Number | 3167338421 |
Enumeration Date | 2006-08-22 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
280 | KS | Behavioral Health & Social Service Providers |
Street Address |
310 W CENTRAL AVE SUITE H |
City | ANDOVER |
State | KS |
Zip Code | 67002-9687 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932348364 | Hearing Healthcare Mid-kansas LLC | Audiologist-Hearing Aid Fitter | 310 W Central Ave, Suite L, Andover, KS 67002-9688 | 2009-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386262707 | Rachel Marie Porter | Nurse Practitioner | Andover Family Medicine, 2117 N Keystone Circle, Andover, KS 67002 | 2020-07-13 |
1033535695 | Michael L Ray | Chiropractor | 1145 N Andover Rd Ste 109, Andover, KS 67002 | 2014-03-06 |
1225372949 | Lisa Hua Lee | Physical Therapy Assistant | 811 N Crescent Lakes Cir, Andover, KS 67002 | 2012-11-19 |
1689992752 | Andover Senior Care, LLC | Skilled Nursing Facility | 224 E Central Ave, Andover, KS 67002 | 2010-05-13 |
1033303136 | Casey T Hummel | Chiropractor | 550 North Andover Road, Andover, KS 67002 | 2007-08-31 |
1801007786 | Kansas Medical Center, LLC | Family Medicine | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
1205929957 | Sitha Uy Miller | Internal Medicine | 943 N. Andover Road, Andover, KS 67002 | 2006-10-02 |
1275644650 | Shala Renee Holman | Physician Assistant | 1124 W. 21st Street, Andover, KS 67002 | 2006-08-31 |
1497869168 | Allan Michael Weilert | Chiropractor | 202 E Rhondda St, Ste A, Andover, KS 67002 | 2006-08-18 |
1407872708 | Lindsay Marie Landers | Family Medicine | 105 S Andover Rd, Suite D, Andover, KS 67002 | 2006-07-14 |
Find all providers in zip 67002 |
Taxonomy Code | 103TB0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Cognitive & Behavioral |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134288269 | Susan Christopherson | Psychologist | 1 Elm Sq, Andover, MA 01810-3643 | 2006-12-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841420353 | Tim R. Hodges | Psychologist | 519 Grove Street, Baldwin City, KS 66006-0065 | 2009-07-17 |
1669662698 | Amy Margaret Jacobsen | Psychologist | 8400 W. 110th Street, Suite 610, Overland Park, KS 66210 | 2007-07-26 |
1558570705 | Lisa R Hale | Psychologist | 10555 Marty St, Ste 100, Overland Park, KS 66212-2555 | 2007-05-22 |
1548384555 | Nancy Jeanne Champlin | Psychologist | 11302 Strang Line Rd, Lenexa, KS 66215-4041 | 2007-03-16 |
1699899674 | Omar Gabriel Gudino | Psychologist | 832 Pennsylvania St Ste 17, Lawrence, KS 66044-2754 | 2007-03-16 |
1598898231 | Karen J Wakefield | Psychologist | 2649 Sw Arrowhead Rd, Topeka, KS 66614-2458 | 2007-03-13 |
1770621674 | Integrated Behavioral Technologies Inc | Psychologist | 1106 N 155th St Ste B, Basehor, KS 66007-7100 | 2007-02-02 |
1700821279 | Priscilla None Wallingford | Psychologist | 13140 El Monte St, Leawood, KS 66209-4159 | 2006-06-18 |
1245278134 | Firststarr Rehabilitation & Behavioral Health, LLC | Psychologist | 4402 E Central Ave, Wichita, KS 67208-3912 | 2006-06-03 |
1023072436 | John Leenay | Psychologist | 727 N Waco Ave Ste 210, Wichita, KS 67203-3953 | 2006-04-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.