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General NPI Number Information
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NPI Number | 1467814376
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Entity Type | Organization
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Legal Business Name | KANSAS CITY THERAPY, LLC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 660 SE BAYBERRY LN STE 105
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City | LEES SUMMIT
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State | MO
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Zip | 64063-4264
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Country | US
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Telephone | 816-599-3918
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Fax |
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Provider Business Mailing Address
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Address Line | 660 SE BAYBERRY LN STE 105
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City | LEES SUMMIT
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State | MO
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Zip | 64063-4264
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Country | US
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Telephone | 816-599-3918
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPY/MEMBER OF LLC
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Name | BERNADETTE ELENA BORCHARDT
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Credential | LCSW
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Telephone | 816-405-9985
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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 | 2013003118
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2011010746
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License Number State | MO
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