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General NPI Number Information
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NPI Number | 1295521797
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Entity Type | Organization
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Legal Business Name | GARDEN OF PERSEPHONE COUNSELING LLC
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 24103 E 323RD ST
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City | HARRISONVILLE
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State | MO
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Zip | 64701-7393
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Country | US
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Telephone | 816-287-0392
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Fax |
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Provider Business Mailing Address
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Address Line | 8426 CLINT DR PMB 311
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City | BELTON
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State | MO
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Zip | 64012-5329
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Country | US
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Telephone | 816-287-0392
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | NATHAN BURSLEY
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Credential | CPA
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Telephone | 816-287-0392
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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 |
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License Number State |
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