Provider Demographics
NPI:1235370495
Name:AWAKENINGS COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:AWAKENINGS COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATTISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:913-530-2577
Mailing Address - Street 1:200 E LOULA ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3437
Mailing Address - Country:US
Mailing Address - Phone:913-530-2577
Mailing Address - Fax:
Practice Address - Street 1:200 E LOULA ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3437
Practice Address - Country:US
Practice Address - Phone:913-530-2577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC1970101YM0800X, 106H00000X
KSLSCSW13791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty