Basic Information
| Provider Information | |||||||||
| NPI: | 1245392463 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARRECA | ||||||||
| FirstName: | LEANORA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10918 ELM AVE. | ||||||||
| Address2: | |||||||||
| City: | KC KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167677608 | ||||||||
| FaxNumber: | 8162516367 | ||||||||
| Practice Location | |||||||||
| Address1: | 10918 ELM AVE. | ||||||||
| Address2: | |||||||||
| City: | KS KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167677608 | ||||||||
| FaxNumber: | 8162516367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 2001022356 | MO | N | Behavioral Health & Social Service Providers | Counselor | 103T00000X | 2015042594 | MO | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.