Healthcare Provider Details

I. General information

NPI: 1710806161
Provider Name (Legal Business Name): KATELYN TRUETT LPC, PLCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 SE 2ND ST STE C
LEES SUMMIT MO
64063-2654
US

IV. Provider business mailing address

16176 COUNTY ROAD 3580
ADA OK
74820-1324
US

V. Phone/Fax

Practice location:
  • Phone: 816-226-8714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number030329
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: