Provider Demographics
NPI:1558020040
Name:AMY ROBERTSON COUNSELING LLC
Entity Type:Organization
Organization Name:AMY ROBERTSON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-226-7298
Mailing Address - Street 1:10118 TRACY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3346
Mailing Address - Country:US
Mailing Address - Phone:816-226-7298
Mailing Address - Fax:816-207-0543
Practice Address - Street 1:10118 TRACY AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3346
Practice Address - Country:US
Practice Address - Phone:816-226-7298
Practice Address - Fax:816-207-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty