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General NPI Number Information
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NPI Number | 1396606927
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Entity Type | Organization
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Legal Business Name | SELORA LLC
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 1111 W 39TH ST APT 202
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City | KANSAS CITY
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State | MO
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Zip | 64111-4616
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Country | US
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Telephone | 913-961-5408
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Fax |
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Provider Business Mailing Address
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Address Line | 621 N CLOVERDALE AVE
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City | INDEPENDENCE
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State | MO
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Zip | 64056-2259
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Country | US
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Telephone | 816-721-7065
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CODY COOK
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Credential |
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Telephone | 816-721-7065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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