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: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 FOXRIDGE DR
MISSION KS
66202-1554
US

IV. Provider business mailing address

2029 BUCHANAN ST
KANSAS CITY MO
64116-3405
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04867
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: