MEDICARE: MR. ROBERT M LINEBARGER M.S.

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	003652	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003652	OTHER	MO	CLINICAL SOCIAL WORKER

General Provider Information

NPI Number	:	1568592251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT M LINEBARGER M.S.

Provider Business Mailing Address
First Line	:	3304 W DEVONSHIRE DR
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-4577
Country	:	US
Telephone Number	:	816-279-4140
Fax Number	:	816-279-4140

Provider Business Practice Location Address
First Line	:	3304 W DEVONSHIRE DR
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-4577
Country	:	US
Telephone Number	:	816-279-4140
Fax Number	:	816-279-4140

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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