Provider Demographics
NPI:1568102416
Name:SARA NELSON-JOHNS
Entity Type:Organization
Organization Name:SARA NELSON-JOHNS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON-JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSCSW
Authorized Official - Phone:013-735-7161
Mailing Address - Street 1:865 NW SOUTH SHORE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WAUKOMIS
Mailing Address - State:MO
Mailing Address - Zip Code:64151-1445
Mailing Address - Country:US
Mailing Address - Phone:913-735-7161
Mailing Address - Fax:
Practice Address - Street 1:104 E 5TH ST STE 201
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1172
Practice Address - Country:US
Practice Address - Phone:913-735-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health