Healthcare Provider Details

I. General information

NPI: 1609417690
Provider Name (Legal Business Name): LAUREN ZOLTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SHAWNEE MISSION PKWY STE L1
MERRIAM KS
66202-2960
US

IV. Provider business mailing address

106 W 14TH ST UNIT 1310
KANSAS CITY MO
64105-2198
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-1297
  • Fax:
Mailing address:
  • Phone: 913-549-8533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11249
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: