| Starboard Therapy And Coaching | |
|
107 W 9th St Kansas City MO 64105-1705 | |
| (816) 659-3202 | |
| Not Available |
| Full Name | Starboard Therapy And Coaching |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 107 W 9th St, Kansas City, Missouri |
| Authorized Official Name and Position | Meagan Leigh Dwyer (OWNER) |
| Authorized Official Contact | 8166593202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Starboard Therapy And Coaching 107 W 9th St Kansas City MO 64105-1705 Ph: (816) 659-3202 | Starboard Therapy And Coaching 107 W 9th St Kansas City MO 64105-1705 Ph: (816) 659-3202 |
| NPI Number | 1326759150 |
|---|---|
| Provider Enumeration Date | 12/13/2022 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 0345611166 |
|---|---|
| Medicare Enrollment ID | O20230113001174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326759150 | NPI | - | NPPES |
| 1700169968 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Megan L Dwyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700169968 PECOS PAC ID: 4082872650 Enrollment ID: I20230113001255 |
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