Provider Demographics
NPI:1487836771
Name:REACHING OUT
Entity Type:Organization
Organization Name:REACHING OUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:816-678-3522
Mailing Address - Street 1:8716 LONGVIEW CT
Mailing Address - Street 2:P.O. BOX11602 KANSAS CITY, MISSOURI 64138
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-3674
Mailing Address - Country:US
Mailing Address - Phone:816-678-3522
Mailing Address - Fax:
Practice Address - Street 1:8716 LONGVIEW CT
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-3674
Practice Address - Country:US
Practice Address - Phone:816-678-3522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty