Healthcare Provider Details

I. General information

NPI: 1881205102
Provider Name (Legal Business Name): MCKENNA ELFRINK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8016 STATE LINE RD STE 115
PRAIRIE VILLAGE KS
66208-3727
US

IV. Provider business mailing address

2440 MONTGALL AVE
KANSAS CITY MO
64127-4029
US

V. Phone/Fax

Practice location:
  • Phone: 913-808-3942
  • Fax:
Mailing address:
  • Phone: 417-699-2518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC03697
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: