Healthcare Provider Details

I. General information

NPI: 1396924064
Provider Name (Legal Business Name): LEAH BROOKE MATHESON MS, LCPC, LPC, CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6240 W 135TH ST STE 200
OVERLAND PARK KS
66223-4849
US

IV. Provider business mailing address

6240 W 135TH ST STE 200
OVERLAND PARK KS
66223-4849
US

V. Phone/Fax

Practice location:
  • Phone: 913-522-0961
  • Fax:
Mailing address:
  • Phone: 913-522-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2232
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1887
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2006031965
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: