MATTHEW R BOTKIN (NPI# 1003937764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003937764 |
| Entity Type | Individual |
| Full Name | MATTHEW R BOTKIN |
| Credential | LCP |
| Practice Address |
6440 Nieman Rd Shawnee KS 66203-3326 |
| Mailing Address |
6000 Lamar Ave Ste 130 Mission KS 66202-3234 |
| Practice Telephone | 9139629955 |
| Practice Fax Number | 9138261589 |
| Mailing Telephone | 9138312550 |
| Mailing Fax Number | 9138261589 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2010-05-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 157 | KS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100098010B | 05 |
| Street Address |
6440 NIEMAN RD |
| City | SHAWNEE |
| State | KS |
| Zip Code | 66203-3326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215999834 | Teresa Renee Palermo | Nurse Practitioner | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2006-04-06 |
| 1518575893 | Connie Semehar Harrington | Nurse Practitioner | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2020-07-22 |
| 1689296626 | Devin Hardy | Social Worker | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2020-05-13 |
| 1013543107 | Heather Mason | Social Worker | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2020-03-20 |
| 1437785664 | Leslie Ruggles | Counselor | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2020-03-19 |
| 1164058343 | Morgan Knight | Social Worker | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2020-03-19 |
| 1629616016 | Erin Ann Reisner | Counselor | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2019-12-16 |
| 1699323949 | Ashley Marmon | Social Worker | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2019-08-29 |
| 1962055616 | Tanise Smith | Counselor | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2019-07-22 |
| 1760044457 | Colyn Jones | Social Worker | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2019-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952897621 | Kelsey Rae Nehrig | Physician Assistant | 7420 Switzer Road, Shawnee, KS 66203 | 2018-07-06 |
| 1215452552 | Joshua L Kiene | Dentist | 11005 W 60th St. #240, Shawnee Mission, KS 66203 | 2017-08-08 |
| 1114276730 | Kimberly Rigsby | Marriage & Family Therapist | 8826 Santa Fe Drive, Suite 210, Shawnee, KS 66203 | 2012-08-29 |
| 1851523567 | Sean Cailteux | Chiropractor | 7410 Switzer Rd, Shawnee, KS 66203 | 2009-08-13 |
| 1609275502 | Stacy Corum | Nurse Practitioner | 7440 W Frontage Rd, Merriam, KS 66203 | 2014-08-15 |
| 1285062695 | Elizabeth Marie Frieze | Psychologist | 7501 College Blvd, Suite 250, Overland Park, KS 66203 | 2013-10-22 |
| 1245636166 | Michaels Mission, LLC | Day Training, Developmentally Disabled Services | 4744 Bond St, Shawnee, KS 66203-1017 | 2014-11-05 |
| 1194983114 | Jenny Grace Cho | Surgery | 7420 Switzer, Shawnee, KS 66203-1239 | 2008-05-27 |
| 1154665586 | Lisa Michele Feiring | Speech-Language Pathologist | 9506 W 48th St, Merriam, KS 66203-1297 | 2012-11-26 |
| 1063908952 | Katrina P Connor | Midwife | 4831 Antioch Rd, Overland Park, KS 66203-1310 | 2018-07-03 |
| Find all providers in zip 66203 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073811659 | Georgia Frangou | Psychologist | 5412 Summit Ct, Shawnee, KS 66216-5101 | 2011-03-07 |
| 1326234782 | David M. Egan | Psychologist | 12314 W 73rd Ter, Shawnee, KS 66216-3673 | 2007-09-19 |
| 1265652622 | Ronald Leon Lybarger | Psychologist | 23402 W 45th Ter, Shawnee, KS 66226-2430 | 2007-04-26 |
| 1942375274 | M Gerald Ball | Psychologist | 819 North Kickapoo, Shawnee, OK 74801 | 2006-11-21 |
| 1619442407 | Danielle Carlson | Psychologist | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2018-10-08 |
| 1346778941 | Shelby Taylor Hopkins | Psychologist | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2017-05-25 |
| 1285042002 | Ken D Bond Jr. | Psychologist | 1127 N Kickapoo Ave, Shawnee, OK 74801-4845 | 2014-07-24 |
| 1144587304 | Jennifer M Jones | Psychologist | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2012-04-12 |
| 1508989153 | Behavioral Medicine Associates, Inc. | Psychologist | 3200 Medical Park Dr, Shawnee, OK 74804-1744 | 2007-04-09 |
| 1205957966 | Michelle Dianne Burchyett | Psychologist | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2007-04-02 |
| Find all providers in SHAWNEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.