MEDICARE: KATHERINE E AMBROSIER GROVES LCSW

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
1	1041C0700X	Clinical Social Worker	2019025799	MO

General Provider Information

NPI Number	:	1285237909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE E AMBROSIER GROVES LCSW

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400S
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 BROADWAY BLVD STE 316
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3305
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:	816-932-1719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	02/22/2022

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