Northland Behavioral Health & Wellness, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2005004519 Issued in MO

Legal business name

NORTHLAND BEHAVIORAL HEALTH & WELLNESS, LLC

Practice address

119 NE 72ND St
Gladstone, MO 64118-1826

Phone

(816) 420-3130

Fax

(816) 734-0083

NPI assigned

Sep 23, 2009

Last updated

Sep 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amy M Shoffner, PSY.D.NPI 1225139553

Title

Psychologist

Phone

(816) 420-3130

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Marie Shoffner, PSY.D.

  • Clinical Psychologist
  • Kansas City, MO
  • NPI 1225139553
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1750615829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 NE 72ND ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641181826",
            "telephone_number": "816-420-3130",
            "fax_number": "816-734-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NE 72ND ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641181826",
            "telephone_number": "816-420-3130",
            "fax_number": "816-734-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND BEHAVIORAL HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "SHOFFNER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "816-420-3130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2005004519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James H. Mutti, DDS MS
• Ana M Newell, BSN, RN
• David Nguyen, PHARM.D.
• Rachel Nicholson, PT, DPT
• Carter Nickell
• Northland Dental
• Northland Internal Medicine M.D.'S P.C.
• Northland Psychological Assessment Services, LLC
• Northland Pyschiatric Specialists, LLC
• Northland Urgent Care LLC

• Psychologist in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.