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NPI Code Detail

MEDICARE: ELLIOTT CLINICAL SERVICES LLC

MEDICARE: ELLIOTT CLINICAL 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1922847748
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLIOTT CLINICAL SERVICES LLC
Provider Business Mailing Address
First Line : 18329 CANTRELL RD
Second Line :
City : LINWOOD
State : KS
Zip : 66052-4536
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9401 INDIAN CREEK PKWY STE 520
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66210-2013
Country : US
Telephone Number : 913-375-3059
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. REBECCA ELLIOTT
Credential :
Telephone Number : 913-375-3059
Provider Enumeration Date : 05/21/2024
Last Update Date : 05/21/2024

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Directions to “ELLIOTT CLINICAL SERVICES LLC ” Practice Location

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