Healthcare Provider Details

I. General information

NPI: 1609784107
Provider Name (Legal Business Name): JPENDARVIS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W 75TH ST STE 114
OVERLAND PARK KS
66204-2241
US

IV. Provider business mailing address

7602 RUSSELL LN
OVERLAND PARK KS
66204-3180
US

V. Phone/Fax

Practice location:
  • Phone: 816-809-6332
  • Fax:
Mailing address:
  • Phone: 816-809-6332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LEIGH PENDARVIS
Title or Position: LICENSED CLINICAL PROFESSIONAL COUN
Credential: LCPC
Phone: 816-809-6332