Healthcare Provider Details

I. General information

NPI: 1275008880
Provider Name (Legal Business Name): CLOVERLEAF COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 SHAWNEE MISSION PKWY STE 216
OVERLAND PARK KS
66202-4005
US

IV. Provider business mailing address

6901 SHAWNEE MISSION PKWY STE 216
OVERLAND PARK KS
66202-4005
US

V. Phone/Fax

Practice location:
  • Phone: 913-725-8481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTINA WINDLER
Title or Position: PSYCHOLOGIST
Credential: MAS/ PSYD
Phone: 913-725-8481