Individual
KEITH E SPARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 889-4610
(816) 474-4914
Mailing address
5128 BROOKSIDE BLVD, KANSAS CITY, MO 64112-2736
(816) 889-4610
(816) 474-4914
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00321
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180
CSAC
MO
Enumeration date
12/04/2006
Last updated
07/08/2007
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