Individual provider Active NPI

Jacob Michael Prestidge

  • Marriage & Family Therapist
  • Overland Park, KS
National Provider Identifier
1073448106
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT03819T Issued in KS
Practice address
9393 W 110TH St Ste 532
Overland Park, KS 66210-1442
Phone
(816) 875-0072
NPI assigned
Jun 18, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT03819T KS Primary

Addresses

Primary practice location

9393 W 110TH St Ste 532
Overland Park, KS 66210-1442

Mailing address

7020 Walmer St
Overland Park, KS 66204-1437
Phone (816) 506-8098

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trailhead Counseling Services LLC CurrentSince Nov 17, 2024 Accepting new patients

Locations

9393 W 110th St
Ste 532
Overland Park, KS 66210
Phone (816) 875-0072

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1073448106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 WALMER ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662041437",
            "telephone_number": "816-506-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 W 110TH ST STE 532",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101442",
            "telephone_number": "816-875-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIDGE",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "LMFT03819T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.