Healthcare Provider Details

I. General information

NPI: 1295091619
Provider Name (Legal Business Name): RESILIENCY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7940 PARALLEL PKWY SUITE 1
KANSAS CITY KS
66112-2050
US

IV. Provider business mailing address

4131 N MULBERRY DR SUITE 245
KANSAS CITY MO
64116-1871
US

V. Phone/Fax

Practice location:
  • Phone: 816-694-9275
  • Fax:
Mailing address:
  • Phone: 816-694-9275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2006012562
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number813
License Number StateKS

VIII. Authorized Official

Name: MRS. LUCY ROLDAN SMITH
Title or Position: COUNSELOR/THERAPIST
Credential: LPC, LCMFT
Phone: 816-694-9275