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General NPI Number Information
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NPI Number | 1649996786
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Entity Type | Organization
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Legal Business Name | WISE COUNSEL LLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 2300 HUTTON ROAD SUITE 112
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City | KANSAS CITY
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State | KS
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Zip | 66109-4424
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Country | US
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Telephone | 913-708-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 3136 N 123RD TER
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City | KANSAS CITY
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State | KS
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Zip | 66109-4537
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Country | US
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Telephone | 913-708-5123
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | WANDA FAYE EASTERWOOD
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Credential |
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Telephone | 913-708-5123
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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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