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General NPI Number Information
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NPI Number | 1659243608
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Entity Type | Organization
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Legal Business Name | BIRCHWOOD MIND BODY CLINIC LLC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 108 W 63RD ST UNIT 7034
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City | KANSAS CITY
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State | MO
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Zip | 64113-3201
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Country | US
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Telephone | 816-715-5906
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Fax |
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Provider Business Mailing Address
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Address Line | 108 W 63RD ST UNIT 7034
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City | KANSAS CITY
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State | MO
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Zip | 64113-3201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON D GILBERT
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Credential | PA-C
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Telephone | 816-715-5906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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