Provider Demographics
NPI:1104690981
Name:DIEDERICH, LINDSAY KAYE (MA, PLPC)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:KAYE
Last Name:DIEDERICH
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4719 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1536
Mailing Address - Country:US
Mailing Address - Phone:913-226-1398
Mailing Address - Fax:
Practice Address - Street 1:8350 N SAINT CLAIR AVE STE 275
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-5114
Practice Address - Country:US
Practice Address - Phone:913-257-3161
Practice Address - Fax:888-967-8977
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023042206101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional