Provider Demographics
NPI:1740831858
Name:KC MENTAL HEALTH COUNSELING, LLC
Entity type:Organization
Organization Name:KC MENTAL HEALTH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:386-846-6241
Mailing Address - Street 1:320 N MERIDIAN ST STE 519
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1724
Mailing Address - Country:US
Mailing Address - Phone:317-643-8850
Mailing Address - Fax:
Practice Address - Street 1:320 N MERIDIAN ST STE 519
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1724
Practice Address - Country:US
Practice Address - Phone:317-643-8850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty