|
| |
|
620 E 18th St Ste 203 Kansas City MO 64108-1513 | |
| (402) 203-5694 | |
| (816) 819-5873 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 620 E 18th St Ste 203, Kansas City, Missouri |
| Authorized Official Name and Position | Holly Ramaeker (OWNER) |
| Authorized Official Contact | 4022035694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 901211 Kansas City MO 64190-1211 Ph: (402) 203-5694 | 620 E 18th St Ste 203 Kansas City MO 64108-1513 Ph: (402) 203-5694 |
| NPI Number | 1861143679 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Medicare PECOS PAC ID | 3274907530 |
|---|---|
| Medicare Enrollment ID | O20230328001769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861143679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Richard Douglas Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518285402 PECOS PAC ID: 0042403008 Enrollment ID: I20101022000141 |
| Provider Name | Hannah Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053886770 PECOS PAC ID: 0143573766 Enrollment ID: I20200102001056 |
| Provider Name | Elizabeth Ann Farrah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902545700 PECOS PAC ID: 0840657276 Enrollment ID: I20230531000206 |
| Provider Name | Alex Richard Mcentire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629041413 PECOS PAC ID: 1355790940 Enrollment ID: I20231207002460 |
| Provider Name | Alisha L Langley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013427020 PECOS PAC ID: 6800249566 Enrollment ID: I20240129004137 |
| Provider Name | Abby E Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316593635 PECOS PAC ID: 6709311707 Enrollment ID: I20241127003933 |
The Faith Housing Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5036 Prospect Ave, Kansas City, MO 64130 Phone: 816-506-6505 Fax: 816-236-7957 | |
Encourage Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4214 Nw Cookingham Rd, Kansas City, MO 64164 Phone: 816-223-6376 | |
Restore Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6155 Oak St Ste B, Kansas City, MO 64113 Phone: 816-607-1775 | |
Partners In Behavioral Milestones, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6412 E 87th St, Kansas City, MO 64138 Phone: 816-501-5138 Fax: 816-777-0626 | |
Aba New Dawn Mo Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Troost Ave # 1198, Kansas City, MO 64108 Phone: 347-975-8525 | |