Healthcare Provider Details

I. General information

NPI: 1558210674
Provider Name (Legal Business Name): ZACHARY STAHL LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 E 117TH ST
KANSAS CITY MO
64134-3701
US

IV. Provider business mailing address

1555 NE RICE RD
LEES SUMMIT MO
64086-5849
US

V. Phone/Fax

Practice location:
  • Phone: 816-966-0900
  • Fax: 816-554-5550
Mailing address:
  • Phone: 816-347-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2024024820
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: