Provider Demographics
NPI:1093540023
Name:ALLEN, KODI LYNN (LMLP)
Entity type:Individual
Prefix:
First Name:KODI
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 W FOREST DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2420
Mailing Address - Country:US
Mailing Address - Phone:785-259-1269
Mailing Address - Fax:
Practice Address - Street 1:5400 COLLEGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1615
Practice Address - Country:US
Practice Address - Phone:913-283-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMLP03224103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical