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NPI Code Detail

MEDICARE: CHILD & ADOLESCENT TRAUMA SERVICES LLP

MEDICARE: CHILD & ADOLESCENT TRAUMA SERVICES LLP
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
1106H00000XMarriage & Family Therapist839KS

General Provider Information

NPI Number : 1689902991
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILD & ADOLESCENT TRAUMA SERVICES LLP
Provider Business Mailing Address
First Line : 630 MINNESOTA AVE
Second Line : SUITE 210
City : KANSAS CITY
State : KS
Zip : 66101-2806
Country : US
Telephone Number : 913-735-4393
Fax Number : 913-735-0188
Provider Business Practice Location Address
First Line : 630 MINNESOTA AVE
Second Line : SUITE 210
City : KANSAS CITY
State : KS
Zip : 66101-2806
Country : US
Telephone Number : 913-735-4393
Fax Number : 913-735-0188
Authorized Official
Title or Position : MANAGING PARTNER
Name : IAN A NEWLIN
Credential : LMFT
Telephone Number : 913-735-4393
Provider Enumeration Date : 11/24/2009
Last Update Date : 11/24/2009

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Directions to “CHILD & ADOLESCENT TRAUMA SERVICES LLP ” Practice Location

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