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1707 E Cedar St Ste 102 Olathe KS 66062-1886 | |
| (816) 977-3178 | |
| (816) 572-6838 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1707 E Cedar St Ste 102, Olathe, Kansas |
| Authorized Official Name and Position | Stacey Elaine Tadokoro (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8169773178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1308 S. Allendale Rd Greenwood MO 64034 Ph: (816) 977-3178 | 1707 E Cedar St Ste 102 Olathe KS 66062-1886 Ph: (816) 977-3178 |
| NPI Number | 1639559685 |
|---|---|
| Provider Enumeration Date | 06/04/2015 |
| Last Update Date | 12/24/2024 |
| Certification Date | 12/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639559685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3935 (Kansas) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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