Provider Demographics
NPI:1316796519
Name:GREENWOOD, EMERA
Entity type:Individual
Prefix:
First Name:EMERA
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 MELROSE LN
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3554
Mailing Address - Country:US
Mailing Address - Phone:913-742-2279
Mailing Address - Fax:
Practice Address - Street 1:8005 W 110TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2619
Practice Address - Country:US
Practice Address - Phone:913-557-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health