Provider Demographics
NPI:1104217397
Name:SOLID GROUND COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:SOLID GROUND COUNSELING CENTER LLC
Other - Org Name:KIM L. BOWERS
Other - Org Type:Other Name
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LCAC
Authorized Official - Phone:620-364-1415
Mailing Address - Street 1:110 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-1353
Mailing Address - Country:US
Mailing Address - Phone:620-364-1415
Mailing Address - Fax:620-364-1915
Practice Address - Street 1:110 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-1353
Practice Address - Country:US
Practice Address - Phone:620-364-1415
Practice Address - Fax:620-364-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
KS2385251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health