Provider Demographics
NPI:1720622004
Name:COMMUNICATION AND CONNECTION THERAPY
Entity Type:Organization
Organization Name:COMMUNICATION AND CONNECTION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:913-213-3398
Mailing Address - Street 1:5600 W 95TH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5600 W 95TH ST STE 216
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-2968
Practice Address - Country:US
Practice Address - Phone:913-601-7633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty