Provider Demographics
NPI:1659596492
Name:COUNSELING RESOURCES, INC.
Entity Type:Organization
Organization Name:COUNSELING RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-647-7726
Mailing Address - Street 1:6840 SILVERHEEL ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-5300
Mailing Address - Country:US
Mailing Address - Phone:913-647-7726
Mailing Address - Fax:913-647-7710
Practice Address - Street 1:511 SW JACKSON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3333
Practice Address - Country:US
Practice Address - Phone:785-232-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS101YA0400X, 103TC0700X, 104100000X, 1041C0700X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200421460AOtherKMAP PROVIDER NUMBER
KS200421460CMedicaid