=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619863644
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PHOEBE CROUCH PLPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2025
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6401 ROCKHILL RD
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-1122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-363-1898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8300 E 85TH TER
-----------------------------------------------------
City | RAYTOWN
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64138-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-812-6747
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 2025017241
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------