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General NPI Number Information
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NPI Number | 1164701546
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Entity Type | Individual
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Provider Name | PAMELA SUE EISENREICH LPC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 4401 NE VIVION RD STE 204
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City | KANSAS CITY
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State | MO
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Zip | 64119-2800
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Country | US
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Telephone | 816-800-9246
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Fax | 816-663-9921
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Provider Business Mailing Address
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Address Line | 4401 NE VIVION RD STE 204
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City | KANSAS CITY
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State | MO
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Zip | 64119-2800
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Country | US
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Telephone | 816-800-9246
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Fax | 816-663-9921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2006009233
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License Number State | MO
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