Sprouse, Douglas Edward
Sprouse, Douglas Edward is an individual health care provider with primary practice located at 3805 Oakland Avenue Suite 102F, Saint Joseph MO 64506. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Sprouse, Douglas Edward can be contacted via phone (816) 671-9604.Contact Information
Primary practice address
3805 Oakland Avenue Suite 102F
Saint Joseph MO 64506
Phone: (816) 671-9604
Fax: (816) 364-2158
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 365 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 001033 | Missouri |
Profile Details
| NPI number | 1790837805 |
|---|---|
| LBN Legal business name | Sprouse, Douglas Edward |
| Credentials | MASTERS IN SOCIAL WO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790837805 | NPPES |
| Other | 19706028 | BLUE CROSS BLUE SHIELD |
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