Provider Demographics
NPI:1104266113
Name:BOYLE, KRIS (LSCSW)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 NIEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3326
Mailing Address - Country:US
Mailing Address - Phone:913-826-4000
Mailing Address - Fax:913-826-1589
Practice Address - Street 1:6000 LAMAR AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3234
Practice Address - Country:US
Practice Address - Phone:913-831-2550
Practice Address - Fax:913-826-1589
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 37431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical