Healthcare Provider Details

I. General information

NPI: 1558300921
Provider Name (Legal Business Name): CHILD ABUSE PREVENTION ASSOCIALTION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E 23RD ST S
INDEPENDENCE MO
64055-1502
US

IV. Provider business mailing address

503 E 23RD ST S
INDEPENDENCE MO
64055-1502
US

V. Phone/Fax

Practice location:
  • Phone: 816-252-8388
  • Fax: 816-252-1337
Mailing address:
  • Phone: 816-252-8388
  • Fax: 816-252-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW005482
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2002030047
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2004030217
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2004019045
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JEANETTA ISSA
Title or Position: CEO
Credential:
Phone: 816-252-8388