| Diakonos Counseling | |
|
4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 | |
| (816) 373-9240 | |
| (816) 373-9243 |
| Full Name | Diakonos Counseling |
|---|---|
| Speciality | Counselor |
| Location | 4200 Little Blue Pkwy, Independence, Missouri |
| Authorized Official Name and Position | Brian Andrew Fidler (BUSINESS ADMINISTRATOR) |
| Authorized Official Contact | 8163739240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakonos Counseling 4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 Ph: (816) 373-9240 | Diakonos Counseling 4200 Little Blue Pkwy Suite 360 Independence MO 64057-8312 Ph: (816) 373-9240 |
| NPI Number | 1164458931 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 04/16/2009 |
| Medicare PECOS PAC ID | 1658323209 |
|---|---|
| Medicare Enrollment ID | O20050211000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164458931 | NPI | - | NPPES |
| Provider Name | Stephanie Fidler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578619359 PECOS PAC ID: 5991800534 Enrollment ID: I20070410000556 |
| Provider Name | Lee A Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497939094 PECOS PAC ID: 1153490628 Enrollment ID: I20080523000342 |
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