Organization
LIFESKILLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GARZA (BUSINESS OPERATIONS MANAGER)
(816) 606-7127
Entity
Organization
Contact information
Practice address
5460 BUENA VISTA ST, ROELAND PARK, KS 66205-2441
(816) 606-7127
Mailing address
1919 NE KNOLLBROOK ST, LEES SUMMIT, MO 64086-3458
(816) 606-7127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8919243
BUSINESS ENTITY ID NUMBER
KS
Enumeration date
07/15/2018
Last updated
07/15/2018
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