Healthcare Provider Details

I. General information

NPI: 1174680904
Provider Name (Legal Business Name): THE CHILDREN'S PLACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 ROCKHILL RD
KANSAS CITY MO
64131-1122
US

IV. Provider business mailing address

6401 ROCKHILL RD
KANSAS CITY MO
64131-1122
US

V. Phone/Fax

Practice location:
  • Phone: 816-363-1898
  • Fax: 816-822-7711
Mailing address:
  • Phone: 816-363-1898
  • Fax: 816-822-7711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: THERESA BYNUM
Title or Position: BILLING & PAYROLL COORDINATOR
Credential:
Phone: 816-363-1898