1245409929 NPI number — POSITIVE OPTIONS COUNSELING SERVICES INCORPORATED

Table of content: (NPI 1245409929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245409929 NPI number — POSITIVE OPTIONS COUNSELING SERVICES INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSITIVE OPTIONS COUNSELING SERVICES INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245409929
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
171 ENGLISH LANDING DR
Provider Second Line Business Mailing Address:
SUITE220
Provider Business Mailing Address City Name:
PARKVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64152-5027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-746-5775
Provider Business Mailing Address Fax Number:
816-746-5775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
171 ENGLISH LANDING DR
Provider Second Line Business Practice Location Address:
SUITE220
Provider Business Practice Location Address City Name:
PARKVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64152-5027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-746-5775
Provider Business Practice Location Address Fax Number:
816-746-5775
Provider Enumeration Date:
02/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PENNE
Authorized Official First Name:
LARINDA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
LICENSED PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
816-746-5775

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  000882 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20248017 . This is a "BLUE CROSS AND BLUE SHIEL" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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