Healthcare Provider Details

I. General information

NPI: 1174450860
Provider Name (Legal Business Name): PREMIER COUNSELING SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 NW 64TH TER STE 201
KANSAS CITY MO
64151-3980
US

IV. Provider business mailing address

5775 NW 64TH TER STE 201
KANSAS CITY MO
64151-3980
US

V. Phone/Fax

Practice location:
  • Phone: 816-599-3615
  • Fax:
Mailing address:
  • Phone: 816-599-3615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: KELLIE GALLEY
Title or Position: OWNER
Credential: LCSW, LSCSW
Phone: 816-599-3615