Provider Demographics
NPI:1588703722
Name:HEYDON, BRIAN P (EDS, LPC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:P
Last Name:HEYDON
Suffix:
Gender:M
Credentials:EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 WARD PKWY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2034
Mailing Address - Country:US
Mailing Address - Phone:816-523-1600
Mailing Address - Fax:816-444-1944
Practice Address - Street 1:8080 WARD PKWY
Practice Address - Street 2:SUITE 330
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2034
Practice Address - Country:US
Practice Address - Phone:816-523-1600
Practice Address - Fax:816-444-1944
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001033781101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist