Healthcare Provider Details

I. General information

NPI: 1417878190
Provider Name (Legal Business Name): KAITLYN ANN ANDERSON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW MURRAY RD
LEES SUMMIT MO
64081-1204
US

IV. Provider business mailing address

14723 EBY ST
OVERLAND PARK KS
66221-2177
US

V. Phone/Fax

Practice location:
  • Phone: 816-272-5656
  • Fax:
Mailing address:
  • Phone: 913-200-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026034039
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: