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Organization

WISE MIND THERAPY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK THOMAS MCGONIGLE LCSW (MANAGER)
(816) 822-0200
Entity
Organization

Contact information

Practice address
217 E 63RD ST, KANSAS CITY, MO 64113-2224
(816) 822-0200
(816) 444-6425
Mailing address
217 E 63RD ST, KANSAS CITY, MO 64113-2224
(816) 822-0200
(816) 444-6425

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2003019074
MO

Other

Enumeration date
07/28/2008
Last updated
07/28/2008
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