Tara Menefee
Individual provider Active NPI Counselor · Sugar Creek, MO
NPI 1346455367 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1346455367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 11603 Ridge Dr
Sugar Creek, MO 64054-1573 - Phone
- (816) 833-1069
- NPI assigned
- May 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
11603 Ridge Dr
Sugar Creek, MO 64054-1573
Mailing address
11603 Ridge Dr
Sugar Creek, MO 64054-1573
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004244250A | Medicaid | KS |
Other providers in Sugar Creek, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.