Provider Demographics
NPI:1366075657
Name:INSTITUTE FOR PSYCHOLOGICAL ADVANCEMENT, LLC
Entity type:Organization
Organization Name:INSTITUTE FOR PSYCHOLOGICAL ADVANCEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LCPC, NCC
Authorized Official - Phone:816-569-1043
Mailing Address - Street 1:PO BOX 481372
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64148-1372
Mailing Address - Country:US
Mailing Address - Phone:816-569-1043
Mailing Address - Fax:
Practice Address - Street 1:4240 BLUE RIDGE BLVD STE 530
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1713
Practice Address - Country:US
Practice Address - Phone:816-569-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty