Provider Demographics
NPI:1639625577
Name:LECLUYSE COUNSELING SERVICES
Entity Type:Organization
Organization Name:LECLUYSE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LECLUYSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-916-7281
Mailing Address - Street 1:209 E 66TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2339
Mailing Address - Country:US
Mailing Address - Phone:816-916-7281
Mailing Address - Fax:
Practice Address - Street 1:222 W GREGORY BLVD
Practice Address - Street 2:STE 310
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1140
Practice Address - Country:US
Practice Address - Phone:816-916-7281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020018281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty