Healthcare Provider Details

I. General information

NPI: 1215672605
Provider Name (Legal Business Name): HOWARD GEORGE DRAKE III LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2022
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 W SPRUCE ST
OLATHE KS
66061-3123
US

IV. Provider business mailing address

6000 LAMAR AVE STE 130
MISSION KS
66202-3234
US

V. Phone/Fax

Practice location:
  • Phone: 913-826-4200
  • Fax:
Mailing address:
  • Phone: 913-826-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number03901
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: