Provider Demographics
NPI:1700632916
Name:SYNESIS THERAPY, LLC
Entity type:Organization
Organization Name:SYNESIS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:816-379-6906
Mailing Address - Street 1:400 NE COLDWATER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-9133
Mailing Address - Country:US
Mailing Address - Phone:816-379-6906
Mailing Address - Fax:
Practice Address - Street 1:1701 SW US HIGHWAY 40 STE 207
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-4647
Practice Address - Country:US
Practice Address - Phone:816-379-6906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health