Organization
KC COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MARIE CREEK (MEMBER)
(816) 210-0725
Entity
Organization
Contact information
Practice address
9393 W 110TH ST STE 515, OVERLAND PARK, KS 66210-1442
(913) 710-0725
Mailing address
4572 SW RAINTREE SHORE DR, LEES SUMMIT, MO 64082-4886
(816) 215-5364
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201280920A
—
KS
Enumeration date
01/07/2020
Last updated
05/13/2020
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