Healthcare Provider Details

I. General information

NPI: 1962250852
Provider Name (Legal Business Name): KIMBERLY HAWLEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6811 SHAWNEE MISSION PKWY STE 310
MISSION KS
66202-4088
US

IV. Provider business mailing address

1107 SE PRINCETON CT
LEES SUMMIT MO
64081-2775
US

V. Phone/Fax

Practice location:
  • Phone: 913-530-3837
  • Fax:
Mailing address:
  • Phone: 785-218-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: