Active NPI
Danielle Carlson
- Group Psychotherapy Psychologist
- Shawnee, KS
National Provider Identifier
1619442407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Group Psychotherapy Psychologist
- License
- 01533
- Practice address
- 6440 Nieman Rd
Shawnee, KS 66203-3326 - Phone
- (913) 826-4200
- Fax
- (913) 826-1589
- NPI assigned
- Oct 8, 2018
- Last updated
- Oct 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 00893 | KS | |
| Psychologist | 103T00000X | 2886 | KS | |
| Group Psychotherapy Psychologist | 103TP2701X | 01533 | KS | Primary |
Addresses
Primary practice location
6440 Nieman Rd
Shawnee, KS 66203-3326
Mailing address
6000 Lamar Ave Ste 130
Mission, KS 66202-3299
Phone (913) 826-4200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00893 | KS | MD | Addiction (Substance Use Disorder) Counselor |
| 01533 | KS | MD | Group Psychotherapy Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson County Mental Health Center | Past | Accepting new patients | |
| Johnson County Mental Health Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mission, KS
- NPI 1174513444
-
- Community/Behavioral Health Agency
- Mission, KS
- NPI 1689324907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1619442407",
"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",
"fax_number": "913-826-1589"
},
{
"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",
"fax_number": "913-826-1589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-08",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "KS",
"license": "00893",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KS",
"license": "2886",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "KS",
"license": "01533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.