Provider Demographics
NPI:1275787574
Name:KC COUNSELORS, LLC
Entity Type:Organization
Organization Name:KC COUNSELORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:H
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LPC
Authorized Official - Phone:816-926-1036
Mailing Address - Street 1:7611 STATE LINE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-6801
Mailing Address - Country:US
Mailing Address - Phone:816-926-1036
Mailing Address - Fax:816-926-1038
Practice Address - Street 1:7611 STATE LINE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-6801
Practice Address - Country:US
Practice Address - Phone:816-926-1036
Practice Address - Fax:816-926-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005009318251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health