Provider Demographics
NPI:1336473958
Name:BROZ COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BROZ COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BROZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-768-2413
Mailing Address - Street 1:1917 NE PETERS CIR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5300
Mailing Address - Country:US
Mailing Address - Phone:573-768-2413
Mailing Address - Fax:
Practice Address - Street 1:1917 NE PETERS CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5300
Practice Address - Country:US
Practice Address - Phone:573-768-2413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007020583251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health