Healthcare Provider Details

I. General information

NPI: 1164333522
Provider Name (Legal Business Name): SARA ATCHISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 W 75TH ST STE 108
MERRIAM KS
66204-2242
US

IV. Provider business mailing address

5530 BRADSHAW ST
SHAWNEE KS
66216-1617
US

V. Phone/Fax

Practice location:
  • Phone: 816-509-7101
  • Fax:
Mailing address:
  • Phone: 816-509-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number03899-T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: