Healthcare Provider Details

I. General information

NPI: 1992443295
Provider Name (Legal Business Name): CAITLIN ELIZABETH SARDELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14844 W 107TH ST
LENEXA KS
66215-4002
US

IV. Provider business mailing address

851 NW 45TH ST
KANSAS CITY MO
64116-4628
US

V. Phone/Fax

Practice location:
  • Phone: 913-386-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026039921
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: