Healthcare Provider Details

I. General information

NPI: 1528996717
Provider Name (Legal Business Name): KATRINA BOCANEGRA LPC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATRINA BOCANEGRA PLPC LPC, LCPC

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 WESTPORT RD STE A
KANSAS CITY MO
64111-4301
US

IV. Provider business mailing address

1511 WESTPORT RD STE A
KANSAS CITY MO
64111-4301
US

V. Phone/Fax

Practice location:
  • Phone: 816-200-7266
  • Fax:
Mailing address:
  • Phone: 816-200-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC04183
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025033239
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: