Healthcare Provider Details

I. General information

NPI: 1770494411
Provider Name (Legal Business Name): AMANDA BURGEN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21344 W 153RD ST
OLATHE KS
66061-5413
US

IV. Provider business mailing address

21350 W 153RD ST
OLATHE KS
66061-5413
US

V. Phone/Fax

Practice location:
  • Phone: 913-499-8100
  • Fax:
Mailing address:
  • Phone: 913-499-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number149801
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: