# VERGE KC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780286757
- **Authorized official:** JOY DURHAM LSCSW, LCSW, LMAC (THERAPIST)
- **Authorized official phone:** (913) 270-2401

## Contact information

- **Practice address:** 4121 W 83RD ST STE 227, PRAIRIE VILLAGE, KS 66208-5323
- **Practice address phone:** (913) 270-2401
- **Mailing address:** 119 W GREGORY BLVD UNIT 8645, KANSAS CITY, MO 64114-1338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2020
- **Last updated:** 11/13/2020