DR. JERRY L WYCKOFF (NPI# 1780774190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780774190 |
| Entity Type | Individual |
| Full Name | DR. JERRY L WYCKOFF |
| Credential | PH.D. |
| Practice Address |
7501 College Blvd. Suite 250 Overland Park KS 66210-1944 |
| Practice Telephone | 9134518550 |
| Practice Fax Number | 9134695266 |
| Mailing Telephone | 9134518550 |
| Mailing Fax Number | 9134695266 |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2008-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | R0309 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS KC | 18879014 | 01 |
| MO | BCBS KC | 18879014 | 01 |
| Street Address |
7501 COLLEGE BLVD. SUITE 250 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66210-1944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740244573 | Susanne Kohn Eyman | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-04-17 |
| 1417027004 | Deanna Marie Sack | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-11-09 |
| 1871662106 | Susan Margaret Nolan | Case Manager/Care Coordinator | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-11-08 |
| 1336218536 | Martin Dale Zehr | Clinical Neuropsychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-11-06 |
| 1588743538 | Phil Elliott Alexander | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-11-02 |
| 1982794384 | Sheryl R. Porter | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-10-14 |
| 1063502474 | Debra Johnson | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-10-14 |
| 1699865006 | Lane Stanton Laird | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-10-14 |
| 1326138736 | Paul Allen Chinn | Psychologist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-10-14 |
| 1134219546 | Theresa Marie Couture | Marriage & Family Therapist | 7501 College Blvd., Suite 250, Overland Park, KS 66210-1944 | 2006-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794302 | Sme Kansas P.a. | General Practice | 7300 West 110th Street, Commerce Plaza 1 7th Floor, Overland Park, KS 66210 | 2019-11-14 |
| 1417591165 | Refractive Cataract Center, LLC | Clinic/Center | 8300 College Boulevard, Suite 201, Overland Park, KS 66210 | 2019-11-05 |
| 1336705730 | Above & Beyond In-home Kansas, LLC | In Home Supportive Care | 7300 W. 110th Street, Suite 700, Overland Park, KS 66210 | 2019-05-13 |
| 1528531720 | Sarah J Sievers | Acupuncturist | 4800 W. 135th St. Suite 200, Leawood, Ks 66224, KS 66210 | 2019-01-10 |
| 1790286326 | Sarah E Hamilton | Physician Assistant | 8490 College Boulevard, Overland, KS 66210 | 2018-02-28 |
| 1730600750 | True Health and Wellness, LLC | Family Medicine | 11879 W. 112th Street, Suite 100, Overland Park, KS 66210 | 2017-06-29 |
| 1639610603 | Kayla Jolene Lawrance | Advanced Practice Midwife | 9202 W. 110th St., Building 36, Overland Park, KS 66210 | 2017-03-10 |
| 1972041952 | Ccrc of Cedar Rapids, LLC | Skilled Nursing Facility | 11827 W 112th St, Suite 103, Overland Park, KS 66210 | 2017-02-09 |
| 1396122008 | Laurie Jean Sansom | Counselor | 8575 W. 110th, Ste. 218, Overland Park, KS 66210 | 2015-05-01 |
| 1790181063 | Susan J. Anderson, Psy.d., Pa | Psychologist | 8500 W. 100th Street, 540, Overland Park, KS 66210 | 2014-11-13 |
| Find all providers in zip 66210 | ||||
| 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 |
|---|---|---|---|---|
| 1487270435 | Inspired Psychiatric Care | Psychologist | 7960 W 135th St Ste 201, Overland Park, KS 66223-1240 | 2020-06-24 |
| 1932740677 | Johanna Nilsson | Psychologist | 3795 W. 95th Street, Overland Park, KS 66206 | 2019-10-03 |
| 1013499656 | Jillian Woodford Wasson | Psychologist | 8700 Indian Creek Pkwy Ste 270, Overland Park, KS 66210-1527 | 2018-08-30 |
| 1255877817 | David Pulcher, Ph.d., LLC | Psychologist | 8575 W. 110th St., Suite 218, Overland Park, KS 66210-2620 | 2017-01-06 |
| 1790181063 | Susan J. Anderson, Psy.d., Pa | Psychologist | 8500 W. 100th Street, 540, Overland Park, KS 66210 | 2014-11-13 |
| 1518393198 | Martina Margrit Windler | Psychologist | 6901 Shawnee Mission Pkwy Ste 216, Overland Park, KS 66202-4005 | 2013-09-16 |
| 1649532714 | Tracey E Litwin | Psychologist | 7180 W. 107th St., Suite 11, Overland Park, KS 66212 | 2012-06-13 |
| 1215221916 | Paul D Wilson | Psychologist | 8575 West 110th Street, 304, Overland Park, KS 66210 | 2011-05-31 |
| 1073738233 | Keith Jacob Kobes | Psychologist | 8575 W. 110th St, 218, Overland Park, KS 66210-2620 | 2007-04-14 |
| 1013050327 | Laura M Scott | Psychologist | 6310 W 74th St, Suite B, Overland Park, KS 66204-2035 | 2007-02-15 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66210 |
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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.