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General NPI Number Information
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NPI Number | 1578377354
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Entity Type | Individual
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Provider Name | KELSEY LEIGH ELLIS LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 9200 GLENWOOD ST STE 104
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City | OVERLAND PARK
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State | KS
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Zip | 66212-1365
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Country | US
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Telephone | 913-423-3669
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Fax |
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Provider Business Mailing Address
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Address Line | 9114 W 113TH ST
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1734
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Country | US
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Telephone | 410-698-7242
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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 | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 03649
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 2024021301
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License Number State | MO
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