Provider Demographics
NPI:1295521797
Name:GARDEN OF PERSEPHONE COUNSELING LLC
Entity type:Organization
Organization Name:GARDEN OF PERSEPHONE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:816-287-0392
Mailing Address - Street 1:8426 CLINT DR
Mailing Address - Street 2:PMB 311
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-5329
Mailing Address - Country:US
Mailing Address - Phone:816-287-0392
Mailing Address - Fax:
Practice Address - Street 1:24103 E 323RD ST
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-7393
Practice Address - Country:US
Practice Address - Phone:816-287-0392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty