Provider Demographics
NPI:1437694841
Name:NEW SEASON COUNSELING LLC
Entity Type:Organization
Organization Name:NEW SEASON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESTNUT-WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-665-6445
Mailing Address - Street 1:7712 NW 69TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-2937
Mailing Address - Country:US
Mailing Address - Phone:816-665-6445
Mailing Address - Fax:
Practice Address - Street 1:8341 NW MACE RD STE 120
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-4618
Practice Address - Country:US
Practice Address - Phone:816-368-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013008441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1437694841Medicaid
MO1386088284Medicaid