| Church Therapy Associates, Llc | |
|
3112 W Grand St Springfield MO 65802-5201 | |
| (781) 367-2383 | |
| Not Available |
| Full Name | Church Therapy Associates, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3112 W Grand St, Springfield, Missouri |
| Authorized Official Name and Position | Kristen Kansiewicz (DIRECTOR, LPC) |
| Authorized Official Contact | 7813672383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Church Therapy Associates, Llc 4223 E State Highway Aa Springfield MO 65803-5772 Ph: (781) 367-2383 | Church Therapy Associates, Llc 3112 W Grand St Springfield MO 65802-5201 Ph: (781) 367-2383 |
| NPI Number | 1992403711 |
|---|---|
| Provider Enumeration Date | 02/21/2023 |
| Last Update Date | 02/21/2023 |
| Certification Date | 02/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992403711 | NPI | - | NPPES |
| 1053428722 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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