Provider Demographics
NPI:1528217171
Name:SCHLOTMAN COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SCHLOTMAN COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHLOTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:816-616-2812
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-0041
Mailing Address - Country:US
Mailing Address - Phone:816-616-2812
Mailing Address - Fax:816-240-8296
Practice Address - Street 1:406 N 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-1680
Practice Address - Country:US
Practice Address - Phone:816-616-2812
Practice Address - Fax:816-240-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0007731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1588638829Medicaid
MO0009046Medicare PIN