Healthcare Provider Details

I. General information

NPI: 1710838693
Provider Name (Legal Business Name): DIVERSIFIED CONSULTING AND THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17188 MO 142
THAYER MO
65791-7758
US

IV. Provider business mailing address

17188 MO 142
THAYER MO
65791-7758
US

V. Phone/Fax

Practice location:
  • Phone: 417-259-2452
  • Fax: 417-322-6099
Mailing address:
  • Phone: 417-259-2452
  • Fax: 417-322-6099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHAWN DENNIS
Title or Position: OWNER
Credential:
Phone: 417-259-2452