Individual provider · Type 1 NPI

Tyann Wiederholt

Mental Health Counselor · Lees Summit, MO

NPI number 1033034749 Active

Practice location

200 NE Missouri Rd
Lees Summit, MO 64086-4722

Call (636) 579-0906 Map

Mailing address

1200 SE 12th Ter
Lees Summit, MO 64081-2170

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X2026034217 (MO)

Mental Health Counselor: Definition to come...

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About NPI 1033034749

Tyann Wiederholt's National Provider Identifier is 1033034749, issued on Aug 11, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lees Summit, MO. The record was last updated on Aug 11, 2026.