Provider Demographics
NPI:1932571601
Name:RESPONSIVE MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:RESPONSIVE MENTAL HEALTH SERVICES LLC
Other - Org Name:RESPONSIVE PSYCHOTHERAPY SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:LILES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:816-214-0155
Mailing Address - Street 1:136 E WALNUT ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-3990
Mailing Address - Country:US
Mailing Address - Phone:816-214-0155
Mailing Address - Fax:816-817-1019
Practice Address - Street 1:136 E WALNUT ST
Practice Address - Street 2:SUITE 107
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-3990
Practice Address - Country:US
Practice Address - Phone:816-214-0155
Practice Address - Fax:816-817-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080017191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty