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General NPI Number Information
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NPI Number | 1538484795
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Entity Type | Organization
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Legal Business Name | SCOTT A. MAID BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 302 E WALL ST
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2490
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Country | US
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Telephone | 816-884-5777
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Fax | 816-884-5778
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Provider Business Mailing Address
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Address Line | 302 E WALL ST
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2490
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Country | US
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Telephone | 816-884-5777
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Fax | 816-884-5778
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT MAID
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Credential | LPC/PLP
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Telephone | 816-884-5777
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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 | 2008036314
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License Number State | MO
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