Provider Demographics
NPI:1356667307
Name:KS COUNSELING LLC
Entity Type:Organization
Organization Name:KS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER-BUMBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:636-724-1224
Mailing Address - Street 1:428 MCDONOUGH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-3483
Mailing Address - Country:US
Mailing Address - Phone:636-724-1224
Mailing Address - Fax:636-724-1226
Practice Address - Street 1:428 MCDONOUGH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-3483
Practice Address - Country:US
Practice Address - Phone:636-724-1224
Practice Address - Fax:636-724-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005028657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO495473001Medicaid