Provider Demographics
NPI:1356626329
Name:HEARTLAND COUNSELING, LLC
Entity Type:Organization
Organization Name:HEARTLAND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:CROLLEY-POLAKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:913-907-9072
Mailing Address - Street 1:8340 MISSION RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1355
Mailing Address - Country:US
Mailing Address - Phone:913-642-0100
Mailing Address - Fax:913-642-0176
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:SUITE 210
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1355
Practice Address - Country:US
Practice Address - Phone:913-642-0100
Practice Address - Fax:913-642-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty