Healthcare Provider Details

I. General information

NPI: 1851737324
Provider Name (Legal Business Name): BRENDA J SALLEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE BLVD
KANSAS CITY KS
66160-4619
US

IV. Provider business mailing address

2106 OLATHE BLVD MS 4004
KANSAS CITY KS
66160-4619
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax: 913-588-2253
Mailing address:
  • Phone: 913-588-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2015032104
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2132
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: