Healthcare Provider Details

I. General information

NPI: 1669851473
Provider Name (Legal Business Name): LORI STAIRS BOHNEN JUSTICE BSN, MS-LMFT, JD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7381 W 133RD ST SUITE 260
OVERLAND PARK KS
66213-4750
US

IV. Provider business mailing address

11525 GRANT DRIVE
OVERLAND PARK KS
66210
US

V. Phone/Fax

Practice location:
  • Phone: 913-647-8092
  • Fax:
Mailing address:
  • Phone: 913-645-6513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2024011825
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2665
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: