| NPI | 1396439345 |
|---|---|
| Doing Business As | FIRESIDE COUNSELING |
| Entity Type | Organization |
| Authorized Contact | JUSTIN MODRELL Clinical Social Worker 913-662-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |