A Therapist Clinical Counseling
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Lees Summit, MO
NPI 1063249159 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1063249159
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- A THERAPIST CLINICAL COUNSELING
- Practice address
- 600 SW Jefferson St
Lees Summit, MO 64063-3988 - Phone
- (816) 237-0006
- NPI assigned
- Sep 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Chanta Tinney, LCSW
- Title
- Behavioral Health Therapist
- Phone
- (816) 237-0006
Practitioners 1
-
Chanta S Tinney, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240927001373 | MO | Part B Supplier - Clinic/Group Practice | 1052842317 |
Receives reassigned benefits from 1 practitioner Practice locations: Lees Summit, MO |
National Provider Directory
Locations
124 S Main St
Independence, MO 64050
Phone (816) 237-0006
410C SE 3rd St
Ste 105
Lees Summit, MO 64063
Phone (816) 786-9742
600 SW Jefferson St
Lees Summit, MO 64063
Phone (816) 237-0006
1534 Burlington St
North Kansas City, MO 64116
Phone (816) 237-0006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
600 SW Jefferson St
Lees Summit, MO 64063-3988
Mailing address
PO Box 21
Lees Summit, MO 64063-0021
Phone (816) 237-0006
Other practice location 1
124 S Main St
Independence, MO 64050-3703
Phone (816) 237-0006
Other practice location 2
1534 Burlington St
North Kansas City, MO 64116-3826
Phone (816) 237-0006
Other providers in Lees Summit, MO
- 360 Degrees Wellness Counseling LLC
- 3Rd St Healthcare LLC
- Aaa Compassionate Care, LP
- Caitlin Aaron
- Afsheen Ishaku Abdullah Patel
- Able Chiro and FM LLC
- Ablelink Smart Living Technologies
All providers in Lees Summit, MO · Mental Health Clinic/Center (Including Community Mental Health Center) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.