Provider Demographics
NPI:1871891689
Name:NELLANS, JAMIE LEA (LSCSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEA
Last Name:NELLANS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W 83RD ST STE 227
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5323
Mailing Address - Country:US
Mailing Address - Phone:785-764-3490
Mailing Address - Fax:
Practice Address - Street 1:6811 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 310
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4031
Practice Address - Country:US
Practice Address - Phone:785-764-3490
Practice Address - Fax:913-229-7511
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical