Laura Flynn, PSY.D.
Individual provider Active NPI Psychologist · Kansas City, MO
NPI 1790056570 · NPPES record last updated Jun 2, 2014
Key facts
- NPI
- 1790056570
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 2011033589 (MO)
- Practice address
- 3100 NE 83Rd St
Suite 1001
Kansas City, MO 64119-4400 - Phone
- (816) 468-0400
- Fax
- (816) 468-6623
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Axon Psychology Group, PC
Practice addresses (Care Compare)
2500 Niles Rd
Suite 7
Saint Joseph, MI 49085-3268
Phone (269) 281-0408
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220314000658 | MI | Practitioner - Clinical Psychologist | 6901065119 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011033589 | MO | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axon Psychology Group, PC | Current |
Accepting new patients | |
| Innovative Senior Care Home Health of Holland LLC | Past | Accepting new patients |
Locations
2500 Niles Rd
Ste 7
Saint Joseph, MI 49085
Phone (269) 281-0407
2500 Niles Rd
Ste 5
Saint Joseph, MI 49085
Phone (269) 281-0408
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2011033589 | MO | Yes |
Addresses
Primary practice location
3100 NE 83Rd St
Suite 1001
Kansas City, MO 64119-4400
Mailing address
3100 NE 83Rd St
Suite 1001
Kansas City, MO 64119-4400
Phone (816) 468-0400
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.