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General NPI Number Information
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NPI Number | 1285793323
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY COUNSELING CENTER, INCORPORATED
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 232 S NEOSHO BLVD SUITE A
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City | NEOSHO
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State | MO
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Zip | 64850-1646
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Country | US
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Telephone | 417-451-5500
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Fax | 417-455-1322
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Provider Business Mailing Address
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Address Line | 232 S NEOSHO BLVD SUITE A
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City | NEOSHO
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State | MO
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Zip | 64850-1646
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Country | US
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Telephone | 417-451-5500
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Fax | 417-455-1322
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Authorized Official
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Title or Position | OWNER &THERAPIST
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Name | MS. LINDA SUSAN KURTZ
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Credential | M.S.W., L.C.S.W.
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Telephone | 417-451-5500
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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 | 2004018766
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License Number State | MO
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