Provider Demographics
NPI:1902390347
Name:COLLEEN RECKER LCSW LSCSW LLC
Entity Type:Organization
Organization Name:COLLEEN RECKER LCSW LSCSW LLC
Other - Org Name:RECKER COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSCSW
Authorized Official - Phone:816-775-0500
Mailing Address - Street 1:204 NE DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2040
Mailing Address - Country:US
Mailing Address - Phone:816-775-0500
Mailing Address - Fax:
Practice Address - Street 1:204 NE DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2040
Practice Address - Country:US
Practice Address - Phone:816-775-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty