Individual
MR. GEORGE M WINE CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.DIV., M.S.
Contact information
Practice address
9233 WARD PKWY, SUITE 305, KANSAS CITY, MO 64114-3366
(816) 824-9898
(816) 527-8052
Mailing address
9233 WARD PKWY, SUITE 305, KANSAS CITY, MO 64114-3366
(816) 824-9898
(816) 527-8052
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2669
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2322864
CIGNA
MO
01
—
27215019
BCBS PROVIDER #
MO
01
—
48-1180532
UBH PROVIDER #
MO
01
—
48118053264111B004
TRICARE
—
01
—
569447
VALUEOPTIONS
MO
01
—
7968347
AETNA
MO
01
—
WINE CHASE
COVENTRY/MHNET
MO
Enumeration date
03/02/2006
Last updated
11/02/2010
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