Provider Demographics
NPI:1710230222
Name:KANSAS CITY THERAPEUTIC INSTITUTE
Entity Type:Organization
Organization Name:KANSAS CITY THERAPEUTIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, RASAC II
Authorized Official - Phone:816-382-3000
Mailing Address - Street 1:7211 NW 83RD ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-6022
Mailing Address - Country:US
Mailing Address - Phone:816-382-3000
Mailing Address - Fax:816-817-1255
Practice Address - Street 1:7211 NW 83RD ST
Practice Address - Street 2:SUITE 250
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-6022
Practice Address - Country:US
Practice Address - Phone:816-382-3000
Practice Address - Fax:816-817-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009032465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty