Natasha Brooke O'Donnell, LCP, LMLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LCP1450 Issued in KS

Practice address

1901 E 1St St
Newton, KS 67114-5010

Phone

(316) 284-6402

NPI assigned

Aug 30, 2011

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Soma Recovery LLC

  • Mental Health Counselor
  • Wichita, KS
  • NPI 1750850723
  Medicare reassignment NPD

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114208576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E 1ST ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671145010",
            "telephone_number": "316-284-6402",
            "fax_number": "316-284-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E 1ST ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671145010",
            "telephone_number": "316-284-6402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 N Tyler Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672123271",
            "country_code": "US",
            "telephone_number": "316-721-8118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 N Exposition St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672035902",
            "country_code": "US",
            "telephone_number": "316-264-8317",
            "fax_number": "316-264-0347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "NATASHA",
        "middle_name": "BROOKE",
        "credential": "LCP, LMLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "T-LMLP 1395",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LMLP2436",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LCP1450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200737670E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kristal Overby

• Clinical Psychologist in Newton, KS
• Providers in Newton, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.