Provider Demographics
NPI:1124462189
Name:SIRRIDGE, KATHRYN MCLEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MCLEAN
Last Name:SIRRIDGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9229 WARD PKWY STE 225
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3311
Mailing Address - Country:US
Mailing Address - Phone:913-579-6410
Mailing Address - Fax:
Practice Address - Street 1:9229 WARD PKWY STE 225
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3311
Practice Address - Country:US
Practice Address - Phone:816-444-5511
Practice Address - Fax:816-822-8058
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015007530103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling