| Authenticity Counseling Llc | |
|
1900 Sw Merryman Dr Lees Summit MO 64082-3913 | |
| (417) 321-5312 | |
| Not Available |
| Full Name | Authenticity Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1900 Sw Merryman Dr, Lees Summit, Missouri |
| Authorized Official Name and Position | Jennifer Elizabeth Corbin-daulton (OWNER) |
| Authorized Official Contact | 4173215312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authenticity Counseling Llc 1900 Sw Merryman Dr Lees Summit MO 64082-3913 Ph: (417) 321-5312 | Authenticity Counseling Llc 1900 Sw Merryman Dr Lees Summit MO 64082-3913 Ph: (417) 321-5312 |
| NPI Number | 1437831310 |
|---|---|
| Provider Enumeration Date | 08/01/2023 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 5991155392 |
|---|---|
| Medicare Enrollment ID | O20231227003017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437831310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennifer E Corbin-daulton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205119013 PECOS PAC ID: 4880977602 Enrollment ID: I20170201001912 |
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