| Epic Counseling Group | |
|
4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 | |
| (816) 622-3171 | |
| Not Available |
| Full Name | Epic Counseling Group |
|---|---|
| Speciality | Counselor |
| Location | 4200 Little Blue Pkwy, Independence, Missouri |
| Authorized Official Name and Position | Brian Fidler (PRESIDENT) |
| Authorized Official Contact | 8166223171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Epic Counseling Group 4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 Ph: () - | Epic Counseling Group 4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 Ph: (816) 622-3171 |
| NPI Number | 1346682994 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 10/09/2013 |
| Medicare PECOS PAC ID | 1254565054 |
|---|---|
| Medicare Enrollment ID | O20131010000845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346682994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (Missouri) | Primary |
| 103TC0700X | Psychologist - Clinical | (Missouri) | Secondary |
| 1041C0700X | Social Worker - Clinical | (Missouri) | Secondary |
| Provider Name | Stephanie Fidler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578619359 PECOS PAC ID: 5991800534 Enrollment ID: I20070410000556 |
| Provider Name | Douglas B Vaughan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578615407 PECOS PAC ID: 6103994611 Enrollment ID: I20081010000610 |
| Provider Name | Connie L Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154466118 PECOS PAC ID: 9638423668 Enrollment ID: I20181110000311 |
| Provider Name | Harold H Mcclellan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386154490 PECOS PAC ID: 2062740269 Enrollment ID: I20190827000547 |
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