Individual provider Active NPI

Alexandria Fortenbery, LPC

  • Mental Health Counselor
  • Kansas City, MO
National Provider Identifier
1619653540
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
202204038 Issued in MO
Practice address
601 E 63Rd St Ste 404
Kansas City, MO 64110-3369
Phone
(913) 605-4132
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 202204038 MO Primary

Addresses

Primary practice location

601 E 63Rd St Ste 404
Kansas City, MO 64110-3369

Mailing address

501 W Country LN
Kansas City, MO 64114
Phone (913) 605-4132

Other practice location 1

400 SW Longview Blvd 160
Lee's Summit, MO 64081
Phone (816) 761-3944

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
202204038MOMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1619653540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W COUNTRY LN",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64114",
            "telephone_number": "913-605-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 63RD ST STE 404",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103369",
            "telephone_number": "913-605-4132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 SW Longview Blvd 160",
            "address_purpose": "LOCATION",
            "city": "Lee's Summit",
            "state": "MO",
            "postal_code": "64081",
            "country_code": "US",
            "telephone_number": "816-761-3944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTENBERY",
        "first_name": "ALEXANDRIA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "202204038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.