Healthcare Provider Details

I. General information

NPI: 1497678445
Provider Name (Legal Business Name): KATELYN SCHROEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN OTTLEY

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 OAK ST STE E-5
KANSAS CITY MO
64113-2240
US

IV. Provider business mailing address

1600 NW 38TH ST APT A300
KANSAS CITY MO
64116-4719
US

V. Phone/Fax

Practice location:
  • Phone: 816-237-8330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2025029053
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: