Healthcare Provider Details

I. General information

NPI: 1063342715
Provider Name (Legal Business Name): LIVING HOPE PSYCHOLOGICAL SERVICE AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 PINETREE DR
COLUMBIA MO
65201-1706
US

IV. Provider business mailing address

3251 PINETREE DR
COLUMBIA MO
65201-1706
US

V. Phone/Fax

Practice location:
  • Phone: 913-730-0035
  • Fax: 660-662-2220
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CARA JOHNSON
Title or Position: OWNER
Credential: MSW, PSYD
Phone: 913-730-0035