Provider Demographics
NPI:1841333010
Name:PRINGLE, PHILLIP LEON (LPC)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:LEON
Last Name:PRINGLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 M 291 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2334
Mailing Address - Country:US
Mailing Address - Phone:816-373-9240
Mailing Address - Fax:816-373-9243
Practice Address - Street 1:3031 M 291 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2334
Practice Address - Country:US
Practice Address - Phone:816-373-9240
Practice Address - Fax:816-373-9243
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional