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NPI Code Detail

MEDICARE: LAURI MASSEY MSW, LCSW

MEDICARE:   LAURI  MASSEY  MSW, 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
11041C0700XClinical Social Worker004118MO

General Provider Information

NPI Number : 1558486126
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURI MASSEY MSW, LCSW
Provider Business Mailing Address
First Line : 1901 E BENNETT ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-1427
Country : US
Telephone Number : 417-827-0191
Fax Number :
Provider Business Practice Location Address
First Line : 1901 E BENNETT ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-1427
Country : US
Telephone Number : 417-827-0191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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Directions to “ LAURI MASSEY MSW, LCSW” Practice Location

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