Organization
WISE MIND THERAPY SERVICES, LLC
Active
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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