Provider Demographics
NPI:1437309143
Name:LOTUS PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:LOTUS PSYCHOLOGICAL SERVICES
Other - Org Name:DR. TARA GUNTHER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNTHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:816-729-3939
Mailing Address - Street 1:PO BOX 165505
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-5505
Mailing Address - Country:US
Mailing Address - Phone:816-729-3939
Mailing Address - Fax:816-926-9180
Practice Address - Street 1:7611 STATE LINE RD
Practice Address - Street 2:SUITE 226
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-6801
Practice Address - Country:US
Practice Address - Phone:816-753-7071
Practice Address - Fax:816-926-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008015962251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health