Healthcare Provider Details

I. General information

NPI: 1740100924
Provider Name (Legal Business Name): CAROLINE HAMBLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W MAIN ST
GREENWOOD MO
64034-9648
US

IV. Provider business mailing address

105C W WALL ST.
HARRISONVILLE MO
64701
US

V. Phone/Fax

Practice location:
  • Phone: 816-974-7378
  • Fax: 816-817-1619
Mailing address:
  • Phone: 816-974-7378
  • Fax: 816-817-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026034168
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: