Healthcare Provider Details

I. General information

NPI: 1558213942
Provider Name (Legal Business Name): RADICAL EMPOWERMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 W 34TH ST STE 406
KANSAS CITY MO
64111-3124
US

IV. Provider business mailing address

406 W 34TH ST STE 406
KANSAS CITY MO
64111-3124
US

V. Phone/Fax

Practice location:
  • Phone: 816-972-1597
  • Fax:
Mailing address:
  • Phone: 816-972-1597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CECIL WATTREE
Title or Position: CLINICAL DIRECTOR/LEAD THERAPIST
Credential: LCSW, LSCSW
Phone: 816-972-1597