| Northland Complete Counseling Llc | |
|
1524 Ne 96th St Ste C Liberty MO 64068-1380 | |
| (816) 379-3007 | |
| (816) 379-3745 |
| Full Name | Northland Complete Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1524 Ne 96th St Ste C, Liberty, Missouri |
| Authorized Official Name and Position | Jordan Davis (OFFICE MANAGER) |
| Authorized Official Contact | 8163793022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northland Complete Counseling Llc 301 Concord Cir Grain Valley MO 64029-9719 Ph: (816) 379-3022 | Northland Complete Counseling Llc 1524 Ne 96th St Ste C Liberty MO 64068-1380 Ph: (816) 379-3007 |
| NPI Number | 1821648205 |
|---|---|
| Provider Enumeration Date | 09/17/2019 |
| Last Update Date | 09/17/2019 |
| Medicare PECOS PAC ID | 9830639509 |
|---|---|
| Medicare Enrollment ID | O20240909002479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821648205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Michael Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306186978 PECOS PAC ID: 4385184050 Enrollment ID: I20240909002595 |
| Provider Name | Sarah Rachel Edelman-dolan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104479278 PECOS PAC ID: 1658811369 Enrollment ID: I20240909003906 |
| Provider Name | Heather Ryan Hawkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750729364 PECOS PAC ID: 6103366877 Enrollment ID: I20240909004107 |
| Provider Name | Kailey Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205448685 PECOS PAC ID: 2961942685 Enrollment ID: I20240909004172 |
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