Stephanie Fennell, LPC

Individual provider Active NPI Professional Counselor · Kansas City, MO

NPI 1154719920 · NPPES record last updated Feb 22, 2022

Key facts

NPI
1154719920
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2015008514 (MO)
Practice address
3211 Woodland Ave
Kansas City, MO 64109-2073
Phone
(816) 931-6500
Fax
(816) 554-4350
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2015008514MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Consultants, Inc. Professional Past Accepting new patients
Communitty Mental Health Consultants, Inc. Professional Past
since May 14, 2016
Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.fennell.npi1154719920.reliant@direct.optumcare.masshiway.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2015008514 MO Yes

Addresses

Primary practice location

3211 Woodland Ave
Kansas City, MO 64109-2073

Mailing address

1555 NE Rice Rd
Lees Summit, MO 64086-5849
Phone (816) 966-0900

Other practice location 1

306 S Independence St
Harrisonville, MO 64701-2352
Phone (816) 380-4010

Other providers in Kansas City, MO

All providers in Kansas City, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.