Organization Active NPI

Gray Horse Mental Wellness LLC

  • Mental Health Counselor
  • Kansas City, KS
National Provider Identifier
1508330101
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GRAY HORSE MENTAL WELLNESS LLC
Practice address
3500 N 99TH St
Kansas City, KS 66109
Phone
(913) 638-1246
NPI assigned
Jan 16, 2019
Last updated
Jan 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Mandy Aycock, LPCNPI 1972928752
Title
Owner, Practitioner
Phone
(913) 638-1246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3500 N 99TH St
Kansas City, KS 66109

Mailing address

4917 Woodstock St
Shawnee, KS 66218-9141
Phone (913) 638-1246

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1508330101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 WOODSTOCK ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662189141",
            "telephone_number": "913-638-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N 99TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66109",
            "telephone_number": "913-638-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY HORSE MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "AYCOCK",
        "authorized_official_first_name": "MANDY",
        "authorized_official_title_or_position": "OWNER, PRACTITIONER",
        "authorized_official_telephone_number": "913-638-1246",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.