Provider Demographics
NPI:1700649209
Name:KC CHARACTER DEVELOPMENT
Entity Type:Organization
Organization Name:KC CHARACTER DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:NICOLAAS
Authorized Official - Last Name:BRUNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMFT, LMFT
Authorized Official - Phone:913-229-6269
Mailing Address - Street 1:6601 W 73RD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2026
Mailing Address - Country:US
Mailing Address - Phone:913-229-6269
Mailing Address - Fax:
Practice Address - Street 1:11900 COLLEGE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4048
Practice Address - Country:US
Practice Address - Phone:913-229-6269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)