Healthcare Provider Details

I. General information

NPI: 1255825048
Provider Name (Legal Business Name): ALLEGRA HARTMAN-FROST LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E 137TH ST
KANSAS CITY MO
64145-1455
US

IV. Provider business mailing address

300 E 36TH ST
KANSAS CITY MO
64111-1410
US

V. Phone/Fax

Practice location:
  • Phone: 816-508-3600
  • Fax: 816-508-3797
Mailing address:
  • Phone: 816-508-1700
  • Fax: 816-508-1757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2018018728
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: