Healthcare Provider Details

I. General information

NPI: 1265874234
Provider Name (Legal Business Name): LAUREN ASHLEY MORET-GLASS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 W 145TH TER
OVERLAND PARK KS
66223-3342
US

IV. Provider business mailing address

8002 W 145TH TER
OVERLAND PARK KS
66223-3342
US

V. Phone/Fax

Practice location:
  • Phone: 305-409-8574
  • Fax:
Mailing address:
  • Phone: 305-409-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW11460
License Number StateFL

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: