Active NPI
Maria Moylan, LMLP
- Clinical Psychologist
- Olathe, KS
National Provider Identifier
1699474395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03202
- Practice address
- 11695 S Blackbob Rd
Olathe, KS 66062-1058 - Phone
- (913) 768-6606
- Fax
- (913) 768-6609
- NPI assigned
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 03202 | KS | Primary |
Addresses
Primary practice location
11695 S Blackbob Rd
Olathe, KS 66062-1058
Mailing address
11695 S Blackbob Rd
Olathe, KS 66062-1058
Phone (913) 768-6606
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 |
|---|---|---|---|
| 03202 | KS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1699474395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11695 S BLACKBOB RD",
"city": "OLATHE",
"state": "KS",
"postal_code": "660621058",
"telephone_number": "913-768-6606",
"fax_number": "913-768-6609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11695 S BLACKBOB RD",
"city": "OLATHE",
"state": "KS",
"postal_code": "660621058",
"telephone_number": "913-768-6606",
"fax_number": "913-768-6609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYLAN",
"first_name": "MARIA",
"credential": "LMLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "03202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.