Healthcare Provider Details

I. General information

NPI: 1841076130
Provider Name (Legal Business Name): EMILY KAY MOORE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 SW BURLINGAME RD
TOPEKA KS
66611-2050
US

IV. Provider business mailing address

PO BOX 844383
DALLAS TX
75284-4383
US

V. Phone/Fax

Practice location:
  • Phone: 785-337-0308
  • Fax: 816-221-9121
Mailing address:
  • Phone: 785-337-0308
  • Fax: 816-221-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2026021230
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSCSW07179
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: