Provider Demographics
NPI:1275753832
Name:BRIAN D PAUL LLC
Entity Type:Organization
Organization Name:BRIAN D PAUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:816-531-2600
Mailing Address - Street 1:411 NICHOLS RD STE 194
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2014
Mailing Address - Country:US
Mailing Address - Phone:816-531-2600
Mailing Address - Fax:816-531-2754
Practice Address - Street 1:411 NICHOLS RD STE 194
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2014
Practice Address - Country:US
Practice Address - Phone:816-531-2600
Practice Address - Fax:816-531-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023863103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000C940Medicare ID - Type Unspecified