MEDICARE: MCDONNELL & ASSOCIATES, LLC

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
1	103TC0700X	Clinical Psychologist	PY01501	MO

General Provider Information

NPI Number	:	1427093855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCDONNELL & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	4010 WASHINGTON ST
Second Line	:	SUITE 401
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2609
Country	:	US
Telephone Number	:	816-561-2374
Fax Number	:	816-561-2374

Provider Business Practice Location Address
First Line	:	4010 WASHINGTON ST
Second Line	:	SUITE 401
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2609
Country	:	US
Telephone Number	:	816-561-2374
Fax Number	:	816-561-2374

Authorized Official
Title or Position	:	MANAGING PARTNER/PSYCHOLOGIST
Name	:	MR. WILLIAM ANDREW MCDONNELL
Credential	:	M.A.
Telephone Number	:	816-561-2374

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/21/2009

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