Healthcare Provider Details

I. General information

NPI: 1093540023
Provider Name (Legal Business Name): KODI LYNN ALLEN LMLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 COLLEGE BLVD STE B
OVERLAND PARK KS
66211-1615
US

IV. Provider business mailing address

914 W FOREST DR
OLATHE KS
66061-2420
US

V. Phone/Fax

Practice location:
  • Phone: 913-283-7704
  • Fax:
Mailing address:
  • Phone: 785-259-1269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCP01568
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLMLP03224
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: