Organization
M. ELIZABETH KINGSLEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY FITCH (CREDENTIALS COORDINATOR)
(913) 851-7780
Entity
Organization
Contact information
Practice address
7611 STATE LINE RD, STE. 226, KANSAS CITY, MO 64114-6801
(816) 753-7071
(816) 926-9180
Mailing address
7611 STATE LINE RD, STE. 226, KANSAS CITY, MO 64114-6801
(816) 753-7071
(816) 926-9180
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00281
MO
106H00000X
Marriage & Family Therapist
084
KS
106H00000X
Marriage & Family Therapist
300045
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10212031
BCBS
MO
05
—
493440218
—
MO
01
—
620005529
RAILROAD MEDICARE
MO
Enumeration date
03/04/2010
Last updated
07/24/2012
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