Provider Demographics
NPI:1902873680
Name:MACRORIE, MICHELLE (PSYD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MACRORIE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4031
Mailing Address - Country:US
Mailing Address - Phone:913-262-5700
Mailing Address - Fax:913-262-5701
Practice Address - Street 1:6811 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4031
Practice Address - Country:US
Practice Address - Phone:913-262-5700
Practice Address - Fax:913-262-5701
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002345103TC0700X
KS1124103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical