| NPI | 1659596492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI CLOCK Exec Assistant 913-647-7726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2019-09-18 |