MEDICARE: ALEXIS SINCLAIR CPS

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	21711	MO

General Provider Information

NPI Number	:	1659297570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS SINCLAIR CPS

Provider Business Mailing Address
First Line	:	3737 S ELIZABETH ST STE 200
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-1785
Country	:	US
Telephone Number	:	816-768-0090
Fax Number	:	816-912-1739

Provider Business Practice Location Address
First Line	:	3737 S ELIZABETH ST STE 200
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-1785
Country	:	US
Telephone Number	:	816-768-0090
Fax Number	:	816-912-1739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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