=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497848501
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA ANN HENSLEY-WARD PSY.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 SE 2ND ST STE 100
-----------------------------------------------------
City | LEES SUMMIT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64063-2759
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-524-5310
-----------------------------------------------------
Fax | 816-524-5578
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7521 BOOTH DR
-----------------------------------------------------
City | PRAIRIE VILLAGE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66208-3634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-433-4141
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 2006029878
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------