Provider Demographics
NPI:1669101291
Name:SCOFIELD, DORIE (MA, MLS, LMFT)
Entity type:Individual
Prefix:
First Name:DORIE
Middle Name:
Last Name:SCOFIELD
Suffix:
Gender:F
Credentials:MA, MLS, LMFT
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:LINICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7401 METCALF AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1975
Mailing Address - Country:US
Mailing Address - Phone:913-660-3191
Mailing Address - Fax:
Practice Address - Street 1:GREGORY HILLS CHURCH OF GOD (HOLINESS)
Practice Address - Street 2:7020 JAMES A REED RD.
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-6620
Practice Address - Country:US
Practice Address - Phone:913-660-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020010321101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2020010321OtherMISSOURI LICENSE NUMBER