MEDICARE: WILSON & MCCABE PSYCHOLOGICAL COUNSELING & CONSULTING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	1294	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	060268	OTHER	VALUE OPTIONS
2	14338013	OTHER	BLUE CROSS BLUE SHIELD
3	7765184	OTHER	AETNA

General Provider Information

NPI Number	:	1396824330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILSON & MCCABE PSYCHOLOGICAL COUNSELING & CONSULTING INC

Provider Business Mailing Address
First Line	:	6220 BLUE RIDGE CUTOFF
Second Line	:	SUITE 206
City	:	KANSAS CITY
State	:	MO
Zip	:	64133-7505
Country	:	US
Telephone Number	:	816-358-8808
Fax Number	:	816-358-8802

Provider Business Practice Location Address
First Line	:	6220 BLUE RIDGE CUTOFF
Second Line	:	SUITE 206
City	:	KANSAS CITY
State	:	MO
Zip	:	64133-7505
Country	:	US
Telephone Number	:	816-358-8808
Fax Number	:	816-358-8802

Authorized Official
Title or Position	:	PSYCHOLOGIST AND OWNER
Name	:	DR. JEAN M MCCABE
Credential	:	PHD
Telephone Number	:	816-358-8808

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/22/2020

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