# KELLY R. MOORE THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285090720
- **Authorized official:** MS. KELLY R. MOORE MSW, LSCSW (THERAPIST)
- **Authorized official phone:** (913) 963-7751

## Contact information

- **Practice address:** 8826 SANTA FE DR, SUITE 210, OVERLAND PARK, KS 66212-3655
- **Practice address phone:** (913) 963-7751
- **Mailing address:** 10360 S HOLLIS LN, OLATHE, KS 66061-7435
- **Mailing address phone:** (913) 963-7751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 4470 | KS | Yes |

## Other

- **Enumeration date:** 01/13/2016
- **Last updated:** 01/13/2016