| State Line Psychiatric Consultants Llc | |
|
1000 Carondelet Dr Kansas City MO 64114-4673 | |
| (816) 607-5700 | |
| Not Available |
| Full Name | State Line Psychiatric Consultants Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1000 Carondelet Dr, Kansas City, Missouri |
| Authorized Official Name and Position | Andrew Harris Kerstein (MEMBER) |
| Authorized Official Contact | 9132229377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| State Line Psychiatric Consultants Llc 6709 W 119th St # 464 Overland Park KS 66209-2013 Ph: (954) 816-1690 | State Line Psychiatric Consultants Llc 1000 Carondelet Dr Kansas City MO 64114-4673 Ph: (816) 607-5700 |
| NPI Number | 1639644131 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/03/2020 |
| Medicare PECOS PAC ID | 5698019479 |
|---|---|
| Medicare Enrollment ID | O20181205001420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639644131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Andrew H Kerstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346473360 PECOS PAC ID: 7315119740 Enrollment ID: I20140124001146 |
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