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Individual

MINDY S KITTERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
8787 BALLENTINE, SUITE 1200, MILL CREEK OUTPATIENT SERVICES, OVERLAND PARK, KS 66214-1979
(913) 339-9933
(913) 339-9915
Mailing address
1408 N ANNE SHIRLEY DR, OLATHE, KS 66061-6790
(913) 904-2893

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAC 133
KS
1041C0700X
Clinical Social Worker
Primary
LSCSW 1575
KS
1041C0700X
Clinical Social Worker
MO 2010033353
MO

Other

Enumeration date
08/17/2007
Last updated
04/03/2012
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