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General NPI Number Information
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NPI Number | 1104223940
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Entity Type | Organization
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Legal Business Name | PARTNERS IN PARENTING EXCELLENCE LLC
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 2906 S MAIN ST
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City | JOPLIN
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State | MO
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Zip | 64804-2639
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Country | US
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Telephone | 417-623-2345
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Fax | 844-272-3899
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Provider Business Mailing Address
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Address Line | 2906 S MAIN ST
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City | JOPLIN
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State | MO
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Zip | 64804-2639
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Country | US
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Telephone | 417-623-2345
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Fax | 844-272-3899
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Authorized Official
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Title or Position | OFFICE MANAGER/PARENT AIDE
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Name | MRS. VANESSA CUSICK
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Credential | BS CANDIDATE
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Telephone | 417-437-9270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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