Provider Demographics
NPI:1689121162
Name:MITCHELL, KRIS (LMFT)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 S CARDINAL PL
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2140
Mailing Address - Country:US
Mailing Address - Phone:913-669-6702
Mailing Address - Fax:
Practice Address - Street 1:400 E BANNISTER RD
Practice Address - Street 2:SUITE A
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3065
Practice Address - Country:US
Practice Address - Phone:816-763-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013008637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist