Basic Information
Provider Information
NPI: 1205434446
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOVE
FirstName: KANA
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6203 E 140TH TER
Address2:  
City: GRANDVIEW
State: MO
PostalCode: 640303890
CountryCode: US
TelephoneNumber: 8164425968
FaxNumber:  
Practice Location
Address1: 480 S ROGERS RD
Address2:  
City: OLATHE
State: KS
PostalCode: 660621706
CountryCode: US
TelephoneNumber: 9133243627
FaxNumber: 9137681437
Other Information
ProviderEnumerationDate: 10/10/2020
LastUpdateDate: 10/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X  Y Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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