Organization
BOULEVARD PSYCHOLOGY, LLC
Active
Organization
BOULEVARD PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY SUSAN EAVES PHD (MANAGING MEMBER)
(913) 499-4302
Entity
Organization
Contact information
Practice address
6240 W 135TH ST STE 200, OVERLAND PARK, KS 66223-4849
(913) 499-4302
(913) 308-0880
Mailing address
6240 W 135TH ST STE 200, OVERLAND PARK, KS 66223-4849
(913) 499-4302
(913) 499-4304
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
KS 811
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19320048
BLUE CROSS BLUE SHIELD
KS
Enumeration date
04/24/2007
Last updated
11/29/2022
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