Healthcare Provider Details

I. General information

NPI: 1730826645
Provider Name (Legal Business Name): TERYN PINNEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 S ROGERS RD
OLATHE KS
66062-1706
US

IV. Provider business mailing address

480 S ROGERS RD
OLATHE KS
66062-1706
US

V. Phone/Fax

Practice location:
  • Phone: 913-764-2887
  • Fax: 913-768-1437
Mailing address:
  • Phone: 913-764-2887
  • Fax: 913-768-1437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06598
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12526
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: