Healthcare Provider Details

I. General information

NPI: 1205317799
Provider Name (Legal Business Name): CALM CONNECTION COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 LONGVIEW ST
SHAWNEE KS
66218-7504
US

IV. Provider business mailing address

5905 LONGVIEW ST
SHAWNEE KS
66218-7504
US

V. Phone/Fax

Practice location:
  • Phone: 913-406-8787
  • Fax:
Mailing address:
  • Phone: 913-406-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number2425
License Number StateKS

VIII. Authorized Official

Name: CANDACE L HOLLOMAN
Title or Position: OWNER
Credential: LPC
Phone: 913-406-8787