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General NPI Number Information
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NPI Number | 1487836771
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Entity Type | Organization
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Legal Business Name | REACHING OUT
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 8716 LONGVIEW CT
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City | KANSAS CITY
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State | MO
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Zip | 64134-3674
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Country | US
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Telephone | 816-678-3522
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Fax |
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Provider Business Mailing Address
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Address Line | 8716 LONGVIEW CT P.O. BOX11602 KANSAS CITY, MISSOURI 64138
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City | KANSAS CITY
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State | MO
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Zip | 64134-3674
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Country | US
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Telephone | 816-678-3522
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DEREK LAMONT SPRUILL SR.
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Credential |
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Telephone | 816-678-3522
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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 | MO
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