Provider Demographics
NPI:1538828819
Name:UNDIVIDED HEART COUNSELING
Entity type:Organization
Organization Name:UNDIVIDED HEART COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-810-7722
Mailing Address - Street 1:7021 E 124TH TER
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-1812
Mailing Address - Country:US
Mailing Address - Phone:816-810-7722
Mailing Address - Fax:
Practice Address - Street 1:1400 N SCOTT AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-1445
Practice Address - Country:US
Practice Address - Phone:816-810-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty