Healthcare Provider Details

I. General information

NPI: 1548081441
Provider Name (Legal Business Name): BAILEY VERHULST LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 ROCKHILL RD
KANSAS CITY MO
64131-1122
US

IV. Provider business mailing address

402 DEWEY ST
GRANDVIEW MO
64030-2946
US

V. Phone/Fax

Practice location:
  • Phone: 816-363-1898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13889
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2024039684
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: