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General NPI Number Information
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NPI Number | 1124747118
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Entity Type | Individual
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Provider Name | KELSEY MOFFITT-CARNEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 101 E CEDAR ST
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City | OLATHE
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State | KS
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Zip | 66061-4416
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Country | US
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Telephone | 913-393-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 S 4TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5013
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Country | US
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Telephone | 913-651-8415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 03174-T
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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