Healthcare Provider Details

I. General information

NPI: 1578661989
Provider Name (Legal Business Name): MICHAEL A ART LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 E US HIGHWAY 40 STE 101
INDEPENDENCE MO
64055-5909
US

IV. Provider business mailing address

3100 BROADWAY BLVD STE 410
KANSAS CITY MO
64111-2655
US

V. Phone/Fax

Practice location:
  • Phone: 816-204-1856
  • Fax: 818-478-8888
Mailing address:
  • Phone: 816-246-8000
  • Fax: 816-247-8207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number001192
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: