Counseling Associates Of Overland Park, Llc | |
12701 Metcalf Ave Ste 204 Overland Park KS 66213-2854 | |
(913) 499-4300 | |
Not Available |
Full Name | Counseling Associates Of Overland Park, Llc |
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Speciality | Psychologist |
Location | 12701 Metcalf Ave Ste 204, Overland Park, Kansas |
Authorized Official Name and Position | Larry William Tyndall (MANAGING MEMBER) |
Authorized Official Contact | 9134994300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Counseling Associates Of Overland Park, Llc 15450 Iron Horse Cir Leawood KS 66224-3852 Ph: (913) 499-4300 | Counseling Associates Of Overland Park, Llc 12701 Metcalf Ave Ste 204 Overland Park KS 66213-2854 Ph: (913) 499-4300 |
NPI Number | 1043378847 |
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Provider Enumeration Date | 12/05/2006 |
Last Update Date | 03/17/2024 |
Certification Date | 03/17/2024 |
Medicare PECOS PAC ID | 8325076557 |
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Medicare Enrollment ID | O20050729000363 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043378847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Larry W Tyndall |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1710971114 PECOS PAC ID: 1951339183 Enrollment ID: I20050803000715 |
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