Healthcare Provider Details

I. General information

NPI: 1043861933
Provider Name (Legal Business Name): CAITLYN SHIRK VIOLETT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN ANN SHIRK

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NE 83RD ST STE 1001
KANSAS CITY MO
64119-4460
US

IV. Provider business mailing address

3100 NE 83RD ST STE 1001
KANSAS CITY MO
64119-4460
US

V. Phone/Fax

Practice location:
  • Phone: 816-877-0488
  • Fax:
Mailing address:
  • Phone: 816-877-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2021001920
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: