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Organization

BRIAN A FIDLER

Active
Parent organization
EPIC COUNSELING GROUP
Other names
Epic Counseling Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
EPIC COUNSELING GROUP
Authorized official
BRIAN FIDLER (PRESIDENT)
(816) 622-3171
Entity
Organization

Contact information

Practice address
4200 LITTLE BLUE PKWY, SUITE 360, INDEPENDENCE, MO 64057-8312
(816) 622-3171
Mailing address
4200 LITTLE BLUE PKWY, SUITE 360, INDEPENDENCE, MO 64057-8312

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MO
103TC0700X
Clinical Psychologist
MO
1041C0700X
Clinical Social Worker
MO

Other

Enumeration date
07/24/2013
Last updated
10/09/2013
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