Healthcare Provider Details

I. General information

NPI: 1235946799
Provider Name (Legal Business Name): CAMILLA HENDREN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MAIN ST STE 900
KANSAS CITY MO
64108-2408
US

IV. Provider business mailing address

2300 MAIN ST STE 900
KANSAS CITY MO
64108-2408
US

V. Phone/Fax

Practice location:
  • Phone: 816-769-4486
  • Fax:
Mailing address:
  • Phone: 816-769-4486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAMILLA HENDREN
Title or Position: CEO
Credential: LCSW
Phone: 816-769-4486