| Summit Therapeutic Services, Llc | |
|
8900 State Line Rd Ste 414 Leawood KS 66206-1960 | |
| (816) 400-3697 | |
| Not Available |
| Full Name | Summit Therapeutic Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8900 State Line Rd Ste 414, Leawood, Kansas |
| Authorized Official Name and Position | Nicholas Alvin Simons-bracken (OWNER/OPERATOR) |
| Authorized Official Contact | 8164003697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Therapeutic Services, Llc 668 Se Bayberry Ln Ste 101 Lees Summit MO 64063-4366 Ph: (816) 500-6436 | Summit Therapeutic Services, Llc 8900 State Line Rd Ste 414 Leawood KS 66206-1960 Ph: (816) 400-3697 |
| NPI Number | 1841766425 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 09/03/2025 |
| Certification Date | 09/03/2025 |
| Medicare PECOS PAC ID | 5395098982 |
|---|---|
| Medicare Enrollment ID | O20181029002284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841766425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brett Thomas Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407227416 PECOS PAC ID: 8022366244 Enrollment ID: I20180803002987 |
| Provider Name | Nicholas Simons Bracken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235561366 PECOS PAC ID: 8224381835 Enrollment ID: I20181107002337 |
| Provider Name | Alicia A Hollis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912789660 PECOS PAC ID: 6305380098 Enrollment ID: I20240705001747 |
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