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General NPI Number Information
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NPI Number | 1861928657
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Entity Type | Individual
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Provider Name | MARCIA PEETZ
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 4401 NE VIVION RD STE 204
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City | KANSAS CITY
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State | MO
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Zip | 64119-2800
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Country | US
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Telephone | 816-799-3720
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Fax |
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Provider Business Mailing Address
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Address Line | 15814 E US HIGHWAY 24
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2015
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Country | US
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Telephone | 816-753-1882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2017004564
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2021030519
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License Number State | MO
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