Provider Demographics
NPI:1912315797
Name:ELIZABETH KAUFMAN THERAPY
Entity type:Organization
Organization Name:ELIZABETH KAUFMAN THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:TLMFT
Authorized Official - Phone:816-914-1340
Mailing Address - Street 1:707 EGRET ST
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-9003
Mailing Address - Country:US
Mailing Address - Phone:816-914-1340
Mailing Address - Fax:
Practice Address - Street 1:8014 STATE LINE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3723
Practice Address - Country:US
Practice Address - Phone:816-914-1340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2575106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty