Healthcare Provider Details

I. General information

NPI: 1336072958
Provider Name (Legal Business Name): MIDWEST PSYCHIATRY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16861 W 93RD PL APT 20209
LENEXA KS
66219-2546
US

IV. Provider business mailing address

16861 W 93RD PL APT 20209
LENEXA KS
66219-2546
US

V. Phone/Fax

Practice location:
  • Phone: 816-295-4919
  • Fax: 865-205-5400
Mailing address:
  • Phone: 816-295-4919
  • Fax: 865-205-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA DANIELLE VAOIFI
Title or Position: NURSE PRACTITIONER
Credential: PMHNP-BC, APRN, NP
Phone: 816-295-4919