Organization
DIAKONOS INC
Active
Other names
Diakonos Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN ANDREW FIDLER (BUSINESS ADMINISTRATOR)
(816) 373-9240
Entity
Organization
Contact information
Practice address
4200 LITTLE BLUE PKWY, SUITE 360, INDEPENDENCE, MO 64057-8312
(816) 373-9240
(816) 373-9243
Mailing address
4200 LITTLE BLUE PKWY, SUITE 360, INDEPENDENCE, MO 64057-8312
(816) 373-9240
(816) 373-9243
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0007690
MO
101YP1600X
Pastoral Counselor
0007690
MO
101YP2500X
Professional Counselor
0007690
MO
103TB0200X
Cognitive & Behavioral Psychologist
0007690
MO
103TC0700X
Clinical Psychologist
0007690
MO
103TC1900X
Counseling Psychologist
0007690
MO
103TC2200X
Clinical Child & Adolescent Psychologist
0007690
MO
106H00000X
Marriage & Family Therapist
0007690
MO
Other
Enumeration date
06/24/2006
Last updated
04/16/2009
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