Healthcare Provider Details

I. General information

NPI: 1063690972
Provider Name (Legal Business Name): ALLIES IN THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5408 W 58TH TER
MISSION KS
66205-2856
US

IV. Provider business mailing address

5408 W 58TH TER
MISSION KS
66205-2856
US

V. Phone/Fax

Practice location:
  • Phone: 913-961-0779
  • Fax: 913-381-4971
Mailing address:
  • Phone: 913-961-0779
  • Fax: 913-381-4971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2272
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. MICHELLE ELISE SCHWARTZ
Title or Position: CLINICAL SOCIAL WORKER
Credential: LSCSW, LCSW
Phone: 913-961-0779