Provider Demographics
NPI:1174762884
Name:CARPENTER, KELLY AMANDA (LPC, LCPC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:AMANDA
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:AMANDA
Other - Last Name:PAPROTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC; MA
Mailing Address - Street 1:PO BOX 9888
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-0888
Mailing Address - Country:US
Mailing Address - Phone:816-508-3472
Mailing Address - Fax:816-508-3425
Practice Address - Street 1:9700 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-1135
Practice Address - Country:US
Practice Address - Phone:816-508-3400
Practice Address - Fax:816-508-3425
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008035918101YP2500X
KSLCPC2249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional