MEDICARE: JANICE BEASLEY 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	003818	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1871687517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE BEASLEY LCSW

Provider Business Mailing Address
First Line	:	3801 DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2807
Country	:	US
Telephone Number	:	816-923-5800
Fax Number	:	816-922-1070

Provider Business Practice Location Address
First Line	:	3801 DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2807
Country	:	US
Telephone Number	:	816-923-5800
Fax Number	:	816-922-1070

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/11/2026

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