Provider Demographics
NPI:1043056583
Name:WESTSIDE FAMILY CHURCH
Entity type:Organization
Organization Name:WESTSIDE FAMILY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE AND COUNSELING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROSZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, LPC
Authorized Official - Phone:913-890-4288
Mailing Address - Street 1:8500 WOODSONIA DR # DD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-3137
Mailing Address - Country:US
Mailing Address - Phone:913-422-8257
Mailing Address - Fax:
Practice Address - Street 1:8500 WOODSONIA DR # DD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-3137
Practice Address - Country:US
Practice Address - Phone:913-422-8257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty