Provider Demographics
NPI:1922177880
Name:PETERS, LOUIS JOSEPH JR (MS DMIN)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:JOSEPH
Last Name:PETERS
Suffix:JR
Gender:M
Credentials:MS DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0065101YA0400X
KS020101YP2500X
MO300113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist