Healthcare Provider Details

I. General information

NPI: 1942111398
Provider Name (Legal Business Name): KAITLIN R LEWIS-LOCKETT PLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLIN R LEWIS

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17844 E 23RD ST S
INDEPENDENCE MO
64057-1840
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 816-254-3652
  • Fax: 816-254-9243
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: