Individual provider Active NPI

Eileen Fratzke

  • Professional Counselor
  • Lees Summit, MO
National Provider Identifier
1053962019
Registry record updated Sep 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2018007774 Issued in MO
Practice address
1272 NE Windsor Dr
Lees Summit, MO 64086-5594
Phone
(816) 246-4465
Fax
(816) 524-7008
NPI assigned
Sep 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2018007774 MO Primary

Addresses

Primary practice location

1272 NE Windsor Dr
Lees Summit, MO 64086-5594

Mailing address

1272 NE Windsor Dr
Lees Summit, MO 64086-5594
Phone (816) 246-4465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2018007774MOMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569024000000",
    "number": "1053962019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-246-4465",
            "fax_number": "816-524-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-246-4465",
            "fax_number": "816-524-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATZKE",
        "first_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-21",
        "last_updated": "2019-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2018007774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.