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NPI Code Detail

MEDICARE: MR. REX O. BLEVINS MA, LPC

MEDICARE: MR. REX O. BLEVINS MA, LPC
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
1101YM0800XMental Health CounselorSC001289MO

General Provider Information

NPI Number : 1295882462
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. REX O. BLEVINS MA, LPC
Provider Business Mailing Address
First Line : 421 E 137TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64145-1455
Country : US
Telephone Number : 816-508-3600
Fax Number : 816-508-3797
Provider Business Practice Location Address
First Line : 421 E 137TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64145-1455
Country : US
Telephone Number : 816-508-3600
Fax Number : 816-508-3797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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