Healthcare Provider Details

I. General information

NPI: 1366106122
Provider Name (Legal Business Name): HEAL ONE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 101ST TER STE 350
KANSAS CITY MO
64131-5310
US

IV. Provider business mailing address

320 W 100TH TER APT 215
KANSAS CITY MO
64114-4449
US

V. Phone/Fax

Practice location:
  • Phone: 816-514-2221
  • Fax:
Mailing address:
  • Phone: 816-920-3263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY MCCRARY
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 816-920-3263