DALLAS RAY GIBSON LARUE LPC NPI 1033648795

NPI Information

NPI: 1033648795
Provider Name: DALLAS RAY GIBSON LARUE, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
300 W 19TH TER
KANSAS CITY, MO
ZIP 64108
Phone: (816) 404-5709
Get Directions

Dallas Ray Gibson Larue, LPC is a professional counselor in Kansas City, MO. Dallas Ray Gibson Larue, LPC NPI is 1033648795. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

300 W 19TH TER
KANSAS CITY, MO
ZIP 64108-026
Phone: (816) 404-5709

The enumeration date for this NPI number is 6/7/2017 and was last updated on 11/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	2016018770	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	490043149	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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