Healthcare Provider Details

I. General information

NPI: 1023941044
Provider Name (Legal Business Name): GEORGIA JOANNA KINSLOW LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8225 COUNTY ROAD 300
CARL JUNCTION MO
64834-7106
US

IV. Provider business mailing address

8225 COUNTY ROAD 300
CARL JUNCTION MO
64834-7106
US

V. Phone/Fax

Practice location:
  • Phone: 417-540-5711
  • Fax:
Mailing address:
  • Phone: 417-540-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025031817
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: