Provider Demographics
NPI:1063422186
Name:DEUTCH, NEAL BARTON (PHD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:BARTON
Last Name:DEUTCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 W 110TH STREET
Mailing Address - Street 2:SUITE 324
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2620
Mailing Address - Country:US
Mailing Address - Phone:913-345-2727
Mailing Address - Fax:913-345-2727
Practice Address - Street 1:8575 W 110TH STREET
Practice Address - Street 2:SUITE 326
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212
Practice Address - Country:US
Practice Address - Phone:913-345-2727
Practice Address - Fax:913-345-1540
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0629103T00000X
MO01185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO496800103Medicaid
KS100238620BMedicaid
MON050000AMedicare UPIN
KSN050000Medicare UPIN
KS100238620BMedicaid
KSN050538Medicare UPIN