Healthcare Provider Details

I. General information

NPI: 1649748401
Provider Name (Legal Business Name): PATTERNS BEHAVIORAL SERVICES KANSAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12760 W 87TH STREET PKWY
LENEXA KS
66215-4635
US

IV. Provider business mailing address

1370 BREA BLVD STE 107
FULLERTON CA
92835-4132
US

V. Phone/Fax

Practice location:
  • Phone: 657-444-9002
  • Fax:
Mailing address:
  • Phone: 657-444-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IHAB SHAHAWI
Title or Position: CEO
Credential:
Phone: 657-444-9002