Provider Demographics
NPI:1578756839
Name:TAKE CHARGE, INC.
Entity Type:Organization
Organization Name:TAKE CHARGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:CLINTON
Authorized Official - Last Name:DICHISER
Authorized Official - Suffix:
Authorized Official - Credentials:L,C,PC
Authorized Official - Phone:913-239-8255
Mailing Address - Street 1:14700 METCALF AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2204
Mailing Address - Country:US
Mailing Address - Phone:913-239-8255
Mailing Address - Fax:866-233-0419
Practice Address - Street 1:14700 METCALF AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2204
Practice Address - Country:US
Practice Address - Phone:913-239-8255
Practice Address - Fax:866-233-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC 239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1114052412OtherPERSONAL NPI
KS30836016OtherBC/BS-KC PROVIDER #