Healthcare Provider Details

I. General information

NPI: 1649861444
Provider Name (Legal Business Name): CLEAR CONSULTING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10109 E 63RD ST
RAYTOWN MO
64133-5103
US

IV. Provider business mailing address

10109 E 63RD ST
RAYTOWN MO
64133-5103
US

V. Phone/Fax

Practice location:
  • Phone: 816-533-6308
  • Fax: 816-662-7632
Mailing address:
  • Phone: 816-533-6308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KENYA HICKS
Title or Position: TRAUMA CLINICIAN
Credential: LCSW, LSCSW
Phone: 816-674-2657