Provider Demographics
NPI:1124132931
Name:COLSON, DONALD B (PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:B
Last Name:COLSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 WEST 83RD ST
Mailing Address - Street 2:SUITE 151
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:913-522-0499
Mailing Address - Fax:913-381-2522
Practice Address - Street 1:4121 W 83RD ST
Practice Address - Street 2:SUITE 227
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5300
Practice Address - Country:US
Practice Address - Phone:913-648-1212
Practice Address - Fax:913-381-2522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP-0300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0008469AMedicare ID - Type Unspecified
R76006Medicare UPIN
KS0008469Medicare ID - Type Unspecified