| A Therapist Clinical Counseling | |
|
600 Sw Jefferson St Lees Summit MO 64063-3988 | |
| (816) 237-0006 | |
| Not Available |
| Full Name | A Therapist Clinical Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Sw Jefferson St, Lees Summit, Missouri |
| Authorized Official Name and Position | Chanta Tinney (BEHAVIORAL HEALTH THERAPIST) |
| Authorized Official Contact | 8162370006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Therapist Clinical Counseling Po Box 21 Lees Summit MO 64063-0021 Ph: (816) 237-0006 | A Therapist Clinical Counseling 600 Sw Jefferson St Lees Summit MO 64063-3988 Ph: (816) 237-0006 |
| NPI Number | 1063249159 |
|---|---|
| Provider Enumeration Date | 09/13/2024 |
| Last Update Date | 09/13/2024 |
| Certification Date | 08/27/2024 |
| Medicare PECOS PAC ID | 1052842317 |
|---|---|
| Medicare Enrollment ID | O20240927001373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063249159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Chanta S Tinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609513191 PECOS PAC ID: 2961933221 Enrollment ID: I20240927001489 |
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