Provider Demographics
NPI:1801413133
Name:CLINICAL COUNSELING ASSOCIATES OF KANSAS CITY LLC
Entity Type:Organization
Organization Name:CLINICAL COUNSELING ASSOCIATES OF KANSAS CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:816-781-8550
Mailing Address - Street 1:100 WESTWOODS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1181
Mailing Address - Country:US
Mailing Address - Phone:816-781-8550
Mailing Address - Fax:
Practice Address - Street 1:100 WESTWOODS DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1181
Practice Address - Country:US
Practice Address - Phone:816-781-8550
Practice Address - Fax:816-792-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty