Individual provider Active NPI

Kelsey Leigh Ellis, LMFT

  • Family Psychologist
  • Overland Park, KS
National Provider Identifier
1578377354
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
2024021301 Issued in MO
Practice address
9200 Glenwood St Ste 104
Overland Park, KS 66212-1365
Phone
(913) 423-3669
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X 03649 KS
Family Psychologist 103TF0000X 2024021301 MO Primary

Addresses

Primary practice location

9200 Glenwood St Ste 104
Overland Park, KS 66212-1365

Mailing address

9114 W 113TH St
Overland Park, KS 66210-1734
Phone (410) 698-7242

Other practice location 1

4710 S Cedar Crest Ct Ste 700
Independence, MO 64055-6997
Phone (816) 537-1350

Other practice location 2

104 N 6th St Ste 7
Atchison, KS 66002-2440
Phone (913) 674-0057

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03649KSMDFamily Psychologist
2024021301MOMDFamily Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1578377354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 W 113TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101734",
            "telephone_number": "410-698-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 GLENWOOD ST STE 104",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121365",
            "telephone_number": "913-423-3669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4710 S Cedar Crest Ct Ste 700",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640556997",
            "country_code": "US",
            "telephone_number": "816-537-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 N 6th St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Atchison",
            "state": "KS",
            "postal_code": "660022440",
            "country_code": "US",
            "telephone_number": "913-674-0057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KELSEY",
        "middle_name": "LEIGH",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "KS",
            "license": "03649",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MO",
            "license": "2024021301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.