Provider Demographics
NPI:1558668319
Name:CHILDREN'S PSYCHOLOGICAL SERVICES INC.
Entity Type:Organization
Organization Name:CHILDREN'S PSYCHOLOGICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:816-444-4887
Mailing Address - Street 1:222 W GREGORY BLVD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1140
Mailing Address - Country:US
Mailing Address - Phone:816-444-4887
Mailing Address - Fax:816-444-4867
Practice Address - Street 1:222 W GREGORY BLVD
Practice Address - Street 2:SUITE 229
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1140
Practice Address - Country:US
Practice Address - Phone:816-444-4887
Practice Address - Fax:816-444-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0747103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100239960 AMedicaid