Healthcare Provider Details
I. General information
NPI: 1376775338
Provider Name (Legal Business Name): COURTNIE LEIGH CAIN PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2009
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14310 E 42ND ST S
INDEPENDENCE MO
64055-7308
US
IV. Provider business mailing address
PO BOX 844715
KANSAS CITY MO
64184-4715
US
V. Phone/Fax
- Phone: 816-254-3652
- Fax:
- Phone: 417-761-5000
- Fax: 417-761-5011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 2022036660 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 1369 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: