Healthcare Provider Details

I. General information

NPI: 1851735468
Provider Name (Legal Business Name): COUNSELORS OBEDIENTLY PREVENTING SUBSTANCE ABUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 AGNES AVE
KANSAS CITY MO
64128-2539
US

IV. Provider business mailing address

3534 WABASH AVE
KANSAS CITY MO
64109-2535
US

V. Phone/Fax

Practice location:
  • Phone: 816-923-9212
  • Fax: 816-921-0022
Mailing address:
  • Phone: 816-923-9212
  • Fax: 816-921-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateMO

VIII. Authorized Official

Name: MISS ANGELA CAROL WESSON
Title or Position: EXECUTIVE DIRECTOR, SA COUNSELOR
Credential: RSAP, BS
Phone: 816-923-9212