Healthcare Provider Details

I. General information

NPI: 1417295221
Provider Name (Legal Business Name): LAURA HEIDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 SPRINT PKWY
OVERLAND PARK KS
66211-1150
US

IV. Provider business mailing address

1707 STEPHENSON LN
SPRING HILL TN
37174-7151
US

V. Phone/Fax

Practice location:
  • Phone: 816-237-2300
  • Fax:
Mailing address:
  • Phone: 219-588-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number262
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3958
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: