Provider Demographics
NPI:1851460711
Name:JAY PETERS INC
Entity Type:Organization
Organization Name:JAY PETERS INC
Other - Org Name:S CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS DMIN
Authorized Official - Phone:816-523-4440
Mailing Address - Street 1:8301 STATE LINE RD
Mailing Address - Street 2:STE 216
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2019
Mailing Address - Country:US
Mailing Address - Phone:816-523-4440
Mailing Address - Fax:816-523-8782
Practice Address - Street 1:8301 STATE LINE RD
Practice Address - Street 2:STE 216
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2019
Practice Address - Country:US
Practice Address - Phone:816-523-4440
Practice Address - Fax:816-523-8782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0065101YA0400X
KS020101YP2500X
MO300113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty