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NPI Code Detail

MEDICARE: DR. WENDY S. EAVES PHD

MEDICARE: DR. WENDY S. EAVES PHD
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
1103TC1900XCounseling PsychologistKS 811KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119320048OTHERKSBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1770596892
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WENDY S. EAVES PHD
Provider Business Mailing Address
First Line : 6240 W 135TH ST STE 200
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66223-4849
Country : US
Telephone Number : 913-499-4302
Fax Number : 913-499-4304
Provider Business Practice Location Address
First Line : 6240 W 135TH ST STE 200
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66223-4849
Country : US
Telephone Number : 913-499-4302
Fax Number : 913-308-0880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 11/29/2022

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