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NPI Code Detail

MEDICARE: MRS. LINDSAY KAYE DIEDERICH MA, PLPC

MEDICARE: MRS. LINDSAY KAYE DIEDERICH MA, PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2023042206MO

General Provider Information

NPI Number : 1104690981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDSAY KAYE DIEDERICH MA, PLPC
Provider Business Mailing Address
First Line : 4719 MOHAWK DR
Second Line :
City : ROELAND PARK
State : KS
Zip : 66205-1536
Country : US
Telephone Number : 913-226-1398
Fax Number :
Provider Business Practice Location Address
First Line : 8350 N SAINT CLAIR AVE STE 275
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-5114
Country : US
Telephone Number : 913-257-3161
Fax Number : 888-967-8977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2023
Last Update Date : 11/13/2023

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