Healthcare Provider Details

I. General information

NPI: 1295190320
Provider Name (Legal Business Name): FERZEEN KHUSHROO PATEL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 BALTIMORE AVE
KANSAS CITY MO
64108-3403
US

IV. Provider business mailing address

101 E OLNEY AVE STE 400
PHILADELPHIA PA
19120-2470
US

V. Phone/Fax

Practice location:
  • Phone: 816-751-7700
  • Fax:
Mailing address:
  • Phone: 215-456-7000
  • Fax: 215-456-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2015040309
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP2364
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018505
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: