Basic Information
| Provider Information | |||||||||
| NPI: | 1881205102 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELFRINK | ||||||||
| FirstName: | MCKENNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10014 WHEELING AVE | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641341278 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4176992518 | ||||||||
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| Practice Location | |||||||||
| Address1: | 480 S ROGERS RD | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133243627 | ||||||||
| FaxNumber: | 9137681437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2020 | ||||||||
| LastUpdateDate: | 08/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3651 | KS | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.