Provider Demographics
NPI:1891527651
Name:PELLINGHELLI, ALYSSA MICHELLE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MICHELLE
Last Name:PELLINGHELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERO
Other - Middle Name:M
Other - Last Name:PELLINGHELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12760 W 87TH STREET PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2878
Mailing Address - Country:US
Mailing Address - Phone:469-309-1633
Mailing Address - Fax:
Practice Address - Street 1:12760 W 87TH STREET PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2878
Practice Address - Country:US
Practice Address - Phone:469-309-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician