Healthcare Provider Details

I. General information

NPI: 1669873865
Provider Name (Legal Business Name): PATRICIA LORD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E DOUGLAS AVE
WICHITA KS
67202-3548
US

IV. Provider business mailing address

7412 W 158TH ST
OVERLAND PARK KS
66223-3699
US

V. Phone/Fax

Practice location:
  • Phone: 913-620-3260
  • Fax:
Mailing address:
  • Phone: 913-620-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2019013521
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2661
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: