Healthcare Provider Details

I. General information

NPI: 1669585543
Provider Name (Legal Business Name): N HANEY & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WESTWOODS DR
LIBERTY MO
64068-3519
US

IV. Provider business mailing address

20 WESTWOODS DR
LIBERTY MO
64068-3519
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-2349
  • Fax: 816-792-8232
Mailing address:
  • Phone: 816-781-2349
  • Fax: 816-792-8232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2007010481
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002019
License Number StateMO

VIII. Authorized Official

Name: MELINDA I HANEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 816-781-2349