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General NPI Number Information
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NPI Number | 1225252364
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Entity Type | Organization
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Legal Business Name | SOUTHWEST MISSOURI COUNSELING
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 516 W MCCORD ST
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City | NEOSHO
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State | MO
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Zip | 64850-1424
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Country | US
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Telephone | 417-451-0624
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Fax | 417-451-0875
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Provider Business Mailing Address
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Address Line | 516 W MCCORD ST PO BOX 485
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City | NEOSHO
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State | MO
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Zip | 64850-1424
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Country | US
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Telephone | 417-451-0624
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Fax | 417-451-0875
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVEN L BRILEY I
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Credential | MACE CSACII ICADC
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Telephone | 417-451-0624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1305 8757
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License Number State | MO
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