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Organization

MODRELL CLINICAL SERVICES LLC

Active
Other names
Fireside Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN MODRELL LSCSW (CLINICAL SOCIAL WORKER)
(913) 662-3627
Entity
Organization

Contact information

Practice address
1201 WAKARUSA DR STE E107, LAWRENCE, KS 66049-3913
(913) 662-3627
Mailing address
1201 WAKARUSA DR STE E107, LAWRENCE, KS 66049-3913
(913) 662-3627

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
06/05/2023
Last updated
06/05/2023
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