Provider Demographics
NPI:1669180386
Name:BURT, LAURA KAY (LMLP-T)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:BURT
Suffix:
Gender:F
Credentials:LMLP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-2957
Mailing Address - Country:US
Mailing Address - Phone:928-225-0269
Mailing Address - Fax:
Practice Address - Street 1:5001 COLLEGE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1618
Practice Address - Country:US
Practice Address - Phone:913-257-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04310101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional