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General NPI Number Information
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NPI Number | 1245781525
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Entity Type | Organization
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Legal Business Name | SPIRIT OF HOPE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 9 VICTORY DR SUITE 2B
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City | LIBERTY
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State | MO
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Zip | 64068-3807
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Country | US
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Telephone | 816-268-8501
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Fax | 816-452-5700
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Provider Business Mailing Address
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Address Line | 4126 NE 82ND ST
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City | KANSAS CITY
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State | MO
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Zip | 64119-7600
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Country | US
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Telephone | 816-468-8731
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Fax | 816-468-8731
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. DEENA WATKINS
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Credential | LPC
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Telephone | 816-468-8731
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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 | 2006012627
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License Number State | MO
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