Healthcare Provider Details

I. General information

NPI: 1306148564
Provider Name (Legal Business Name): IN HOME FAMILY COUNSELING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2010
Last Update Date: 11/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10732 W 115TH ST
OVERLAND PARK KS
66210-3004
US

IV. Provider business mailing address

10732 W 115TH ST
OVERLAND PARK KS
66210-3004
US

V. Phone/Fax

Practice location:
  • Phone: 913-952-9643
  • Fax: 888-441-5613
Mailing address:
  • Phone: 913-952-9643
  • Fax: 888-441-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number687
License Number StateKS

VIII. Authorized Official

Name: MR. WALTER LOUIS
Title or Position: OWNER
Credential: MS, LCMFT
Phone: 913-952-9643