Jennifer Pendarvis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

04032 Issued in KS

Practice address

6440 Nieman Rd
Shawnee, KS 66203-3326

Phone

(913) 826-4200

NPI assigned

Dec 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Johnson County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mission, KS
  • NPI 1174513444
  Medicare reassignment NPD
• Johnson County Mental Health Center

  • Community/Behavioral Health Agency
  • Mission, KS
  • NPI 1689324907
  NPD (past)

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1447721196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 LAMAR AVE STE 130",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662023299",
            "telephone_number": "913-826-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 NIEMAN RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033326",
            "telephone_number": "913-826-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDARVIS",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "04032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Pautz
• Kanecia Shariah Payne
• Curtis Peavler
• Leeann Peck, BCBA
• Robert Pedroza
• Angela Penrose
• Rachel Matilyn Perez, LMSW
• Anne Marie Perry
• Lacie Chalayne Perry
• Kathryn Louise Petelin, DO

• Professional Counselor in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Professional Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.