Basic Information
Provider Information
NPI: 1932577095
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SATTERFIELD
FirstName: DJ
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10550 MARTY ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662122557
CountryCode: US
TelephoneNumber: 9139526696
FaxNumber:  
Practice Location
Address1: 10550 MARTY ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662122557
CountryCode: US
TelephoneNumber: 9139526696
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/07/2015
LastUpdateDate: 09/07/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XT-LMFT2680KSY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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