| Prairie Fire Wellness Llc | |
|
5251 W 116th Pl Ste 209 Leawood KS 66211-7820 | |
| (913) 522-0961 | |
| Not Available |
| Full Name | Prairie Fire Wellness Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5251 W 116th Pl Ste 209, Leawood, Kansas |
| Authorized Official Name and Position | Leah B Matheson (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 9135220961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Fire Wellness Llc 5401 College Blvd Ste 111 Leawood KS 66211-1626 Ph: (816) 588-1704 | Prairie Fire Wellness Llc 5251 W 116th Pl Ste 209 Leawood KS 66211-7820 Ph: (913) 522-0961 |
| NPI Number | 1508362229 |
|---|---|
| Provider Enumeration Date | 04/02/2018 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508362229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2232 (Kansas) | Primary |
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