Healthcare Provider Details

I. General information

NPI: 1386341709
Provider Name (Legal Business Name): MOXIE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 03/12/2023
Certification Date: 03/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 63RD ST STE 360
KANSAS CITY MO
64110-3377
US

IV. Provider business mailing address

411 NW LINCOLNWOOD DR
LEES SUMMIT MO
64063-2106
US

V. Phone/Fax

Practice location:
  • Phone: 816-328-3864
  • Fax:
Mailing address:
  • Phone: 636-233-5861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MACKENZIE SAINZ
Title or Position: OWNER
Credential: LPC, LCPC
Phone: 816-328-3864