Organization · NPI-2

Archetype Therapy LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Kansas City, MO

NPI number1487558938
StatusActive
Last updated in NPPESOct 7, 2026

Details

NPI
1487558938
Entity type
Organization (NPI-2)
Legal business name
Archetype Therapy LLC
Organization subpart
No
Enumeration date
Oct 7, 2026
Certification date
Oct 7, 2026
Last updated
Oct 7, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

3701 Ne 46th St
Kansas City, MO 64117-1229

Phone 214-543-8870

Mailing address

3701 Ne 46th St
Kansas City, MO 64117-1229

Phone 214-543-8870

Authorized official

Dianna Christine Obermueller
Owner
2145438870

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