Judith A Kotecki-Martin, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LCP 026 Issued in KS

Practice address

7840 Washington Ave
Kansas City, KS 66112-2152

Phone

(913) 328-4631

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialty

Mental Health Counselor

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wyandot Center for Community Behavioral Healthcare IncGroup PAC ID 5496745325, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wyandot Center for Community Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Kansas City, KS
  • NPI 1629159389
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508916420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 S 56TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661061523",
            "telephone_number": "913-328-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 WASHINGTON AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661122152",
            "telephone_number": "913-328-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTECKI-MARTIN",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LCP 026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Max Josef Koss
• Benjamin Kossman
• Kamen Kossow, MD
• George Kostanian, MD
• Sathya Tej Kosuri
• Brandon Kotschwar, DPT
• Konstantinos Kourelis, MD
• Anthony L Kovac, MD
• Jack Kovarik, MD
• James Robert Kovarik III, PA

• Clinical Psychologist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.