Provider Demographics
NPI:1568287894
Name:MENDEZ, ISAIAS (LPC)
Entity type:Individual
Prefix:MR
First Name:ISAIAS
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 E 123RD TER APT A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5803
Mailing Address - Country:US
Mailing Address - Phone:913-485-6939
Mailing Address - Fax:
Practice Address - Street 1:1312 E 123RD TER APT A
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5803
Practice Address - Country:US
Practice Address - Phone:913-485-6939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional