| Breakthrough Counseling Kc, Llc | |
|
4801 S Cliff Ave Ste 214a Independence MO 64055-7015 | |
| (816) 875-6868 | |
| (816) 875-4199 |
| Full Name | Breakthrough Counseling Kc, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4801 S Cliff Ave Ste 214a, Independence, Missouri |
| Authorized Official Name and Position | Marie Styles (OWNER) |
| Authorized Official Contact | 8163096449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Counseling Kc, Llc Po Box 1577 Independence MO 64055-0577 Ph: (816) 875-6868 | Breakthrough Counseling Kc, Llc 4801 S Cliff Ave Ste 214a Independence MO 64055-7015 Ph: (816) 875-6868 |
| NPI Number | 1073270120 |
|---|---|
| Provider Enumeration Date | 11/23/2021 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Medicare PECOS PAC ID | 4486041563 |
|---|---|
| Medicare Enrollment ID | O20220419001875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073270120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marie S. Styles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497220842 PECOS PAC ID: 5395132476 Enrollment ID: I20220419002073 |
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