Provider Demographics
NPI:1366767659
Name:CLEVERDON, BARBARA GAYE (LCMFT)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:GAYE
Last Name:CLEVERDON
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12165 PARALLEL PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-4536
Mailing Address - Country:US
Mailing Address - Phone:913-515-6919
Mailing Address - Fax:913-721-2154
Practice Address - Street 1:6824 LACKMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9595
Practice Address - Country:US
Practice Address - Phone:913-515-6919
Practice Address - Fax:913-721-2154
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT314106H00000X
MO2009010880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist