Healthcare Provider Details

I. General information

NPI: 1073269247
Provider Name (Legal Business Name): STARTING POINT OUTPATIENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2022
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 ILLINOIS AVE
JOPLIN MO
64801-5044
US

IV. Provider business mailing address

930 ILLINOIS AVE
JOPLIN MO
64801-5044
US

V. Phone/Fax

Practice location:
  • Phone: 417-553-0043
  • Fax: 417-553-0081
Mailing address:
  • Phone: 417-553-0043
  • Fax: 417-553-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY JANE YOUNG
Title or Position: DIRECTOR/OWNER
Credential: CRADC/MAT/CPS/CGDC
Phone: 417-553-0043