Provider Demographics
NPI:1083630818
Name:CHAFIN, KEVIN JOE (LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JOE
Last Name:CHAFIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 BROADWAY ST STE 218
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2448
Mailing Address - Country:US
Mailing Address - Phone:816-753-1881
Mailing Address - Fax:816-753-5551
Practice Address - Street 1:3100 BROADWAY ST STE 218
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2448
Practice Address - Country:US
Practice Address - Phone:816-753-1881
Practice Address - Fax:816-753-5551
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003029830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional