Healthcare Provider Details

I. General information

NPI: 1962317842
Provider Name (Legal Business Name): DANIEL PAGE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29875 W 339TH ST
OSAWATOMIE KS
66064-4159
US

IV. Provider business mailing address

15912 W 154TH ST
OLATHE KS
66062-3118
US

V. Phone/Fax

Practice location:
  • Phone: 866-455-2878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05503
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: