Provider Demographics
NPI:1588117543
Name:FRONK, MARILYN (LPC, LAC)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:FRONK
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8629 BLUEJACKET ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1604
Mailing Address - Country:US
Mailing Address - Phone:913-677-3553
Mailing Address - Fax:913-677-3282
Practice Address - Street 1:2001 CLAFLIN RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3415
Practice Address - Country:US
Practice Address - Phone:785-587-4300
Practice Address - Fax:785-587-4377
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS955101YA0400X
KS1021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)