=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487690988
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOI MCNELEY-PHELPS PH D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2006
-----------------------------------------------------
Last Update Date | 11/21/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12351 W 96TH TER SUITE 111
-----------------------------------------------------
City | LENEXA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66215-4409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-787-0400
-----------------------------------------------------
Fax | 913-273-1167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12351 W 96TH TER SUITE 111
-----------------------------------------------------
City | LENEXA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66215-4409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-787-0400
-----------------------------------------------------
Fax | 913-273-1167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 0992
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 2003005720
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------