| Clinical Counseling Associates Of Kansas City Llc | |
|
100 Westwoods Dr Liberty MO 64068-1181 | |
| (816) 781-8550 | |
| (816) 792-3219 |
| Full Name | Clinical Counseling Associates Of Kansas City Llc |
|---|---|
| Speciality | Counselor |
| Location | 100 Westwoods Dr, Liberty, Missouri |
| Authorized Official Name and Position | Jill Robinson (OWNER) |
| Authorized Official Contact | 8167818550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Counseling Associates Of Kansas City Llc 100 Westwoods Dr Liberty MO 64068-1181 Ph: (816) 781-8550 | Clinical Counseling Associates Of Kansas City Llc 100 Westwoods Dr Liberty MO 64068-1181 Ph: (816) 781-8550 |
| NPI Number | 1801413133 |
|---|---|
| Provider Enumeration Date | 07/02/2020 |
| Last Update Date | 12/17/2021 |
| Certification Date | 12/17/2021 |
| Medicare PECOS PAC ID | 9234545153 |
|---|---|
| Medicare Enrollment ID | O20210301001834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801413133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael C Wieberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518486075 PECOS PAC ID: 7214354935 Enrollment ID: I20200826002473 |
| Provider Name | Marie Clifton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447732193 PECOS PAC ID: 0648686576 Enrollment ID: I20210301001990 |
| Provider Name | Johnny Clymore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891292843 PECOS PAC ID: 8325447212 Enrollment ID: I20210526000745 |
| Provider Name | Cheree Mccallon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891429197 PECOS PAC ID: 1557742558 Enrollment ID: I20220722000469 |
| Provider Name | Stephanie Fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356944045 PECOS PAC ID: 5890168199 Enrollment ID: I20230308000651 |
| Provider Name | Tate M Goss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568948024 PECOS PAC ID: 4880074970 Enrollment ID: I20230816003507 |
| Provider Name | Gabrielle Naomi Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427668284 PECOS PAC ID: 7012366677 Enrollment ID: I20231208000977 |
| Provider Name | Susan Cimino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043927601 PECOS PAC ID: 0941653646 Enrollment ID: I20240130000732 |
| Provider Name | Montana Bright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215519608 PECOS PAC ID: 7416300041 Enrollment ID: I20240130002067 |
| Provider Name | Susan E Le Dean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841590460 PECOS PAC ID: 8729431309 Enrollment ID: I20240131000207 |
| Provider Name | Amy Post |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629716477 PECOS PAC ID: 8628415908 Enrollment ID: I20240321003590 |
| Provider Name | Duane Lundervold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164686481 PECOS PAC ID: 3779998703 Enrollment ID: I20240322003122 |
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