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General NPI Number Information
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NPI Number | 1932571601
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Entity Type | Organization
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Legal Business Name | RESPONSIVE MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 136 E WALNUT ST SUITE 107
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City | INDEPENDENCE
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State | MO
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Zip | 64050-3990
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Country | US
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Telephone | 816-214-0155
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Fax | 816-817-1019
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Provider Business Mailing Address
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Address Line | 136 E WALNUT ST SUITE 107
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City | INDEPENDENCE
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State | MO
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Zip | 64050-3990
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Country | US
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Telephone | 816-214-0155
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Fax | 816-817-1019
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. JENNIFER D. LILES
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Credential | LCSW
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Telephone | 816-214-0155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2008001719
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License Number State | MO
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