Provider Demographics
NPI:1245781525
Name:SPIRIT OF HOPE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SPIRIT OF HOPE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-468-8731
Mailing Address - Street 1:4126 NE 82ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-7600
Mailing Address - Country:US
Mailing Address - Phone:816-468-8731
Mailing Address - Fax:816-468-8731
Practice Address - Street 1:9 VICTORY DR
Practice Address - Street 2:SUITE 2B
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3807
Practice Address - Country:US
Practice Address - Phone:816-268-8501
Practice Address - Fax:816-452-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012627251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health