Alive Family Psychiatry LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Leavenworth, KS

NPI 1114815917 · NPPES record last updated Jul 8, 2025

Key facts

NPI
1114815917
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
ALIVE FAMILY PSYCHIATRY LLC
Practice address
380 Limit St
Leavenworth, KS 66048-4525
Phone
(816) 845-8550
Fax
(816) 219-6965
NPI assigned
Jun 27, 2025
Organization subpart
No

Authorized official

Name
Julia W Fields, PMHNP-BC
Title
Ceo
Phone
(816) 845-8550

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260122003167 KS Part B Supplier - Clinic/Group Practice 7618454471 Receives reassigned benefits from 5 practitioners
Practice locations: Leavenworth, KS

National Provider Directory

Tax ID family
Alive Family Psychiatry (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

380 Limit St
Leavenworth, KS 66048-4525

Mailing address

380 Limit St
Leavenworth, KS 66048-4525
Phone (816) 845-8550

Other names

  • Alive Family Psychiatry Former legal business name

Other providers in Leavenworth, KS

All providers in Leavenworth, KS · Psychiatric/Mental Health Nurse Practitioner in Kansas

Sources for this page

Verify at the official NPI Registry.