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General NPI Number Information
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NPI Number | 1194978247
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Entity Type | Organization
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Legal Business Name | R B SHONKWILER LLC
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Dates
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Enumeration Date | 11/01/2008
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Last Update Date | 11/01/2008
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Provider Practice Location Address
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Address Line | 12735 EWING AVE
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City | GRANDVIEW
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State | MO
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Zip | 64030-2055
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Country | US
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Telephone | 816-304-7793
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Fax |
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Provider Business Mailing Address
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Address Line | 12735 EWING AVE
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City | GRANDVIEW
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State | MO
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Zip | 64030-2055
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Country | US
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Telephone | 816-304-7793
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING SERVICES
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Name | MR. ROBERT B SHONKWILER
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Credential | LPC
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Telephone | 816-304-7793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2007035389
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2007035389
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License Number State | MO
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