Provider Demographics
NPI:1376082263
Name:SOULLIERE, JEFFREY ALLEN (PLPC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:SOULLIERE
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E 59TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3300
Mailing Address - Country:US
Mailing Address - Phone:816-927-5745
Mailing Address - Fax:
Practice Address - Street 1:2000 E 59TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-3300
Practice Address - Country:US
Practice Address - Phone:816-927-5745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03764101YM0800X
MO2023048881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health