Mark Lawrence Prochaska, M.D.

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

04-21187 Issued in KS

Practice address

7011 W 121St St
Ste 105
Overland Park, KS 66209-2029

Phone

(913) 345-1191

Fax

(913) 345-1464

NPI assigned

Jun 25, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417953290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 W 121ST ST",
            "address_2": "STE 105",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092029",
            "telephone_number": "913-345-1191",
            "fax_number": "913-345-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 W 121ST ST",
            "address_2": "STE 105",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092029",
            "telephone_number": "913-345-1191",
            "fax_number": "913-345-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "MARK",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-21187",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "KS",
            "license": "04-21187",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "KS",
            "license": "04-21187",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "KS",
            "license": "04-21187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Forensic Psychiatry Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Forensic Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.