Healthcare Provider Details

I. General information

NPI: 1942393541
Provider Name (Legal Business Name): MIDWEST CHRISTIAN COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 MAIN SUITE G29
KANSAS CITY MO
64112
US

IV. Provider business mailing address

4800 MAIN SUITE G29
KANSAS CITY MO
64112
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-3726
  • Fax: 816-561-7412
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVE EHMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 816-561-3726