MEDICARE: TENFOLD COUNSELING GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2015004221	MO

General Provider Information

NPI Number	:	1154866606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENFOLD COUNSELING GROUP, LLC

Provider Business Mailing Address
First Line	:	107 W 9TH ST
Second Line	:	SUITE 302
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-1705
Country	:	US
Telephone Number	:	816-423-2593
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 W 9TH ST
Second Line	:	SUITE 302
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-1705
Country	:	US
Telephone Number	:	816-423-2593
Fax Number	:

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	MRS. CRYSTAL MARIE RODENBAUGH
Credential	:	LCSW
Telephone Number	:	816-423-2593

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	12/19/2016

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