MEDICARE: PATRICK REGAN SCANTLIN 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	004832	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C168483	OTHER	MO	MEDICARE B WHEATLANDS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386615334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK REGAN SCANTLIN LCSW

Provider Business Mailing Address
First Line	:	10107 CENTRAL ST APT 307
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-4683
Country	:	US
Telephone Number	:	816-943-6386
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 BROADWAY BLVD
Second Line	:	410
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2658
Country	:	US
Telephone Number	:	816-753-3333
Fax Number	:

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

Provider Enumeration Date	:	01/29/2006
Last Update Date	:	07/14/2014

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