Healthcare Provider Details

I. General information

NPI: 1982361705
Provider Name (Legal Business Name): ALYSSIA ROENNENGART LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 N REVERE DR STE 270
KANSAS CITY MO
64151-3919
US

IV. Provider business mailing address

6300 N REVERE DR STE 270
KANSAS CITY MO
64151-3919
US

V. Phone/Fax

Practice location:
  • Phone: 816-575-7717
  • Fax:
Mailing address:
  • Phone: 816-575-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2026022070
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: