Healthcare Provider Details

I. General information

NPI: 1356211007
Provider Name (Legal Business Name): JESSICA BURCHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10540 MARTY ST STE 220
OVERLAND PARK KS
66212-2656
US

IV. Provider business mailing address

10540 MARTY ST STE 220
OVERLAND PARK KS
66212-2656
US

V. Phone/Fax

Practice location:
  • Phone: 913-912-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9023
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: