1245781525 NPI number — SPIRIT OF HOPE COUNSELING SERVICES, LLC

Table of content: SHANISE DELIVEYON BILLINGS LCSW (NPI 1316672108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245781525 NPI number — SPIRIT OF HOPE COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPIRIT OF HOPE COUNSELING SERVICES, LLC
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:
1245781525
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4126 NE 82ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64119-7600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-468-8731
Provider Business Mailing Address Fax Number:
816-468-8731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 VICTORY DR
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068-3807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-268-8501
Provider Business Practice Location Address Fax Number:
816-452-5700
Provider Enumeration Date:
10/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WATKINS
Authorized Official First Name:
DEENA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
816-468-8731

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  2006012627 , 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)





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