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NPI 1104683390

NPI 1104683390 : AURORAS COMPASS LLC : SHAWNEE, KS

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General NPI Number Information
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    NPI Number           |    1104683390
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    Entity Type          |    Organization 
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    Legal Business Name  |    AURORAS COMPASS LLC 
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Dates
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    Enumeration Date     |    03/04/2024
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    Last Update Date     |    03/11/2024
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Provider Practice Location Address
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    Address Line         |    6511 LAKECREST DR 
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    City                 |    SHAWNEE
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    State                |    KS
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    Zip                  |    66218-8429
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    Country              |    US
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    Telephone            |    913-710-5517
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6511 LAKECREST DR 
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    City                 |    SHAWNEE
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    State                |    KS
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    Zip                  |    66218-8429
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    Country              |    US
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    Telephone            |    913-710-5517
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DAWN MICHELLE CLOUSE 
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    Credential           |    LSCSW
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    Telephone            |    913-710-5517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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