Healthcare Provider Details

I. General information

NPI: 1629998968
Provider Name (Legal Business Name): CALLA SUMMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 NE 83RD ST
KANSAS CITY MO
64119-4458
US

IV. Provider business mailing address

17205 PENROSE LN
LENEXA KS
66219-8121
US

V. Phone/Fax

Practice location:
  • Phone: 816-327-7955
  • Fax:
Mailing address:
  • Phone: 217-899-6887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026021547
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: