Healthcare Provider Details

I. General information

NPI: 1952158628
Provider Name (Legal Business Name): CLAIRE DEVOLDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 FOXRIDGE DR
MISSION KS
66202-1554
US

IV. Provider business mailing address

PO BOX 844383
DALLAS TX
75284-4383
US

V. Phone/Fax

Practice location:
  • Phone: 816-221-0305
  • Fax:
Mailing address:
  • Phone: 816-221-0305
  • Fax: 816-221-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2024049245
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC04867
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: