Healthcare Provider Details

I. General information

NPI: 1972649416
Provider Name (Legal Business Name): SARAH SHANNON KUCHINSKI MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 WORNALL RD
KANSAS CITY MO
64114-5806
US

IV. Provider business mailing address

8150 WORNALL RD
KANSAS CITY MO
64114-5806
US

V. Phone/Fax

Practice location:
  • Phone: 816-508-3500
  • Fax: 816-508-3204
Mailing address:
  • Phone: 816-508-3500
  • Fax: 816-508-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2001009454
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: