Healthcare Provider Details

I. General information

NPI: 1730682519
Provider Name (Legal Business Name): LYDIA D KORTE S-MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2018
Last Update Date: 07/23/2026
Certification Date:
Deactivation Date: 04/15/2019
Reactivation Date: 07/23/2026

III. Provider practice location address

3601 MAIN ST
KANSAS CITY MO
64111-1908
US

IV. Provider business mailing address

127 W 10TH ST APT 809
KANSAS CITY MO
64105-1870
US

V. Phone/Fax

Practice location:
  • Phone: 316-218-7748
  • Fax:
Mailing address:
  • Phone: 316-218-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: