Healthcare Provider Details

I. General information

NPI: 1831867944
Provider Name (Legal Business Name): AUSTIN M LENTZ LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 19TH TER
KANSAS CITY MO
64108-2026
US

IV. Provider business mailing address

8018 MOHAWK ST APT 201
PRAIRIE VILLAGE KS
66208-5129
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-5709
  • Fax:
Mailing address:
  • Phone: 913-220-8660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2021040418
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11097
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: