Provider Demographics
NPI:1487690988
Name:MCNELEY-PHELPS, JOI (PH D)
Entity type:Individual
Prefix:DR
First Name:JOI
Middle Name:
Last Name:MCNELEY-PHELPS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:JOI
Other - Middle Name:
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12351 W 96TH TER
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4409
Mailing Address - Country:US
Mailing Address - Phone:913-787-0400
Mailing Address - Fax:913-273-1167
Practice Address - Street 1:12351 W 96TH TER
Practice Address - Street 2:SUITE 111
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4409
Practice Address - Country:US
Practice Address - Phone:913-787-0400
Practice Address - Fax:913-273-1167
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2009-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0992103T00000X
MO2003005720103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS20-8787353OtherTAX ID
KS100360570AMedicaid
KSS83092Medicare UPIN
KS100360570AMedicaid