MEDICARE: DUNLAP AND ASSOCIATES COUNSELING SERVICES 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	2373	KS

General Provider Information

NPI Number	:	1427360460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUNLAP AND ASSOCIATES COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	6220 BLUE RIDGE CUT OFF STE 312
Second Line	:
City	:	RAYTOWN
State	:	MO
Zip	:	64133-3730
Country	:	US
Telephone Number	:	816-591-6266
Fax Number	:

Provider Business Practice Location Address
First Line	:	8613 E 54TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64129-2213
Country	:	US
Telephone Number	:	816-591-6266
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. TRACY DELON DUNLAP
Credential	:	LCSW
Telephone Number	:	816-591-6266

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	07/07/2010

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