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General NPI Number Information
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NPI Number | 1366767659
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Entity Type | Individual
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Provider Name | BARBARA GAYE CLEVERDON LCMFT
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Gender | Female
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 6824 LACKMAN RD
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City | SHAWNEE
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State | KS
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Zip | 66217-9595
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Country | US
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Telephone | 913-515-6919
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Fax | 913-721-2154
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Provider Business Mailing Address
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Address Line | 12165 PARALLEL PKWY
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City | KANSAS CITY
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State | KS
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Zip | 66109-4536
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Country | US
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Telephone | 913-515-6919
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Fax | 913-721-2154
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCMFT314
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2009010880
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License Number State | MO
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