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NPI Code Detail

MEDICARE: MS. VICKI KAY CEDERBURG LCSW, LSCSW, ACSW

MEDICARE:  MS. VICKI KAY CEDERBURG  LCSW, LSCSW, ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLSCSW 960KS

General Provider Information

NPI Number : 1083623417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICKI KAY CEDERBURG LCSW, LSCSW, ACSW
Provider Business Mailing Address
First Line : 1104 SE COUNTRY LN
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64081-3094
Country : US
Telephone Number : 816-308-0065
Fax Number :
Provider Business Practice Location Address
First Line : 1104 SE COUNTRY LN
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64081-3094
Country : US
Telephone Number : 816-308-0065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 06/29/2012

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Directions to “ MS. VICKI KAY CEDERBURG LCSW, LSCSW, ACSW” Practice Location

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