Basic Information
| Provider Information | |||||||||
| NPI: | 1447292180 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOHN T BOPP PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BEHEAVIORAL HEALTH PARTNERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6155 OAK ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641132238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163330606 | ||||||||
| FaxNumber: | 8165235418 | ||||||||
| Practice Location | |||||||||
| Address1: | 6155 OAK ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641132238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163330606 | ||||||||
| FaxNumber: | 8165235418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 11/09/2007 | ||||||||
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| AuthorizedOfficialLastName: | COTTRELL | ||||||||
| AuthorizedOfficialFirstName: | MARY ANN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8163330606 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 1041C0700X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 103TC0700X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.