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NPI Code Detail

MEDICARE: MRS. BRENDA KAY LEE STOOPS MA, LMHC

MEDICARE: MRS. BRENDA KAY LEE STOOPS MA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39001280AIN
2101YP2500XProfessional CounselorLCPC2402KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117515OTHERINPARTNERS HEALTH PLAN
24431OTHERINIUPM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124019708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA KAY LEE STOOPS MA, LMHC
Provider Business Mailing Address
First Line : PO BOX 688
Second Line :
City : INDEPENDENCE
State : KS
Zip : 67301-0688
Country : US
Telephone Number : 620-331-1748
Fax Number : 620-332-1940
Provider Business Practice Location Address
First Line : 3751 W MAIN ST
Second Line :
City : INDEPENDENCE
State : KS
Zip : 67301-8446
Country : US
Telephone Number : 620-331-1748
Fax Number : 620-332-1940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 03/09/2015

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