Healthcare Provider Details

I. General information

NPI: 1538652219
Provider Name (Legal Business Name): JORDYN CHAFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDYN ENDICOTT

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 NIEMAN RD
SHAWNEE KS
66203-3326
US

IV. Provider business mailing address

6000 LAMAR AVE STE 130
MISSION KS
66202-3299
US

V. Phone/Fax

Practice location:
  • Phone: 913-826-4200
  • Fax: 913-826-1589
Mailing address:
  • Phone: 913-826-4200
  • Fax: 913-826-1589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07211
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: