Healthcare Provider Details

I. General information

NPI: 1366229627
Provider Name (Legal Business Name): GRETCHEN ROSE PERLINGER LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 W 95TH ST STE 100
OVERLAND PARK KS
66212-1434
US

IV. Provider business mailing address

3014 ROWLAND AVE
KANSAS CITY KS
66104-4168
US

V. Phone/Fax

Practice location:
  • Phone: 913-209-6510
  • Fax:
Mailing address:
  • Phone: 913-909-4304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07269
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: