MEDICARE: MS. KORTNEY ANGELA CARR LMSW

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	104100000X	Social Worker	6996	KS
2	104100000X	Social Worker	2011009976	MO

General Provider Information

NPI Number	:	1780878975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KORTNEY ANGELA CARR LMSW

Provider Business Mailing Address
First Line	:	2907 CLEVELAND AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-1254
Country	:	US
Telephone Number	:	816-726-9735
Fax Number	:

Provider Business Practice Location Address
First Line	:	2907 CLEVELAND AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-1254
Country	:	US
Telephone Number	:	816-726-9735
Fax Number	:

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

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	09/16/2013

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