| Personal & Family Development Services Ptr | |
|
4400 Broadway St Suite 410 Kansas City MO 64111-3498 | |
| (816) 756-0684 | |
| (816) 756-0604 |
| Full Name | Personal & Family Development Services Ptr |
|---|---|
| Speciality | Psychologist |
| Location | 4400 Broadway St, Kansas City, Missouri |
| Authorized Official Name and Position | Riley James Bishop (OFFICE MANAGER) |
| Authorized Official Contact | 8167560684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal & Family Development Services Ptr 4400 Broadway St Suite 410 Kansas City MO 64111-3498 Ph: (816) 756-0684 | Personal & Family Development Services Ptr 4400 Broadway St Suite 410 Kansas City MO 64111-3498 Ph: (816) 756-0684 |
| NPI Number | 1578770954 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 02/28/2012 |
| Medicare PECOS PAC ID | 8325093578 |
|---|---|
| Medicare Enrollment ID | O20050321000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578770954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY00112 (Missouri) | Primary |
| Provider Name | Riley James Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952458606 PECOS PAC ID: 1052358116 Enrollment ID: I20050411001182 |
| Provider Name | Linda M Joslyn Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861549529 PECOS PAC ID: 4688612245 Enrollment ID: I20120316000753 |
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