Wellformed AI

NPI 1780378984 · live from the CMS NPI Registry

Minuteclinic Diagnostic Of Kansas PA

Social Worker, Clinical in Independence, MO. National Provider Identifier 1780378984, active.

NPI record

NPI1780378984 Type 2 · organization
StatusActive
Primary specialtySocial Worker, Clinical 1041C0700X
Practice location3825 S Noland Rd, Independence, MO 64055
Practice phone855-417-2486
Mailing addressPo Box 772, Woonsocket, RI 02895
EnumeratedJune 8, 2023
Last updatedJune 8, 2023
Authorized officialDeborah Pincince, Administrator

Taxonomies and licenses

TaxonomyCodeLicense
Counselor, Professional101YP2500X—
Marriage & Family Therapist106H00000X—
Social Worker, Clinical primary1041C0700X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.