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Contact Information

FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION
3515 S 4TH STREET
LEAVENWORTH, KS66048
 Phone: 913-651-8415
 Fax: 913-772-8580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION

NPI Number 1013076215
LBN Legal business name FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION
Authorized official WILLIAM MOFFITT - (VICE PRESIDENT OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/06/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
KS Other 004517 BCBS KANSAS
KS Other 08422011 BCBS KANSAS CITY
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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