Healthcare Provider Details

I. General information

NPI: 1497367379
Provider Name (Legal Business Name): DENITA HOARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 03/24/2024
Certification Date: 03/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 BROADWAY BLVD
KANSAS CITY MO
64111-2501
US

IV. Provider business mailing address

7516 STERLING AVE
RAYTOWN MO
64138-2449
US

V. Phone/Fax

Practice location:
  • Phone: 816-753-5144
  • Fax:
Mailing address:
  • Phone: 816-878-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2023005580
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2020005286
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: