Healthcare Provider Details

I. General information

NPI: 1831017706
Provider Name (Legal Business Name): KAITLYN LEE WYNNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLYN LEE BARNETT

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 BUCHANAN ST
KANSAS CITY MO
64116-3405
US

IV. Provider business mailing address

12020 NW YUKON ST
KANSAS CITY MO
64152-1348
US

V. Phone/Fax

Practice location:
  • Phone: 816-221-0305
  • Fax:
Mailing address:
  • Phone: 816-810-0848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026032199
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: