Provider Demographics
NPI:1467490029
Name:PROFESSIONAL COUNSELING ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL COUNSELING ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCSW
Authorized Official - Phone:816-232-0077
Mailing Address - Street 1:501 S 36TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2952
Mailing Address - Country:US
Mailing Address - Phone:816-232-0077
Mailing Address - Fax:816-232-0077
Practice Address - Street 1:501 S 36TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2952
Practice Address - Country:US
Practice Address - Phone:816-232-0077
Practice Address - Fax:816-232-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty