Provider Demographics
NPI:1487260048
Name:KINETIC CURE COUNSELING INC
Entity type:Organization
Organization Name:KINETIC CURE COUNSELING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:A
Authorized Official - Last Name:VROOM
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:816-288-2918
Mailing Address - Street 1:12409 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-3097
Mailing Address - Country:US
Mailing Address - Phone:816-651-0997
Mailing Address - Fax:
Practice Address - Street 1:6310 LAMAR AVE STE 100
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66202-4284
Practice Address - Country:US
Practice Address - Phone:816-288-2918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA201267130Medicaid
1063873206OtherNPI