Healthcare Provider Details

I. General information

NPI: 1225971922
Provider Name (Legal Business Name): MICHELLE HILLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

3821 BALTIMORE AVE
KANSAS CITY MO
64111-2118
US

IV. Provider business mailing address

3821 BALTIMORE AVE
KANSAS CITY MO
64111-2118
US

V. Phone/Fax

Practice location:
  • Phone: 573-814-9488
  • Fax:
Mailing address:
  • Phone: 573-814-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025012827
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: