Healthcare Provider Details

I. General information

NPI: 1881236800
Provider Name (Legal Business Name): REBECCA LINDQUIST LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6436
LEES SUMMIT MO
64064-6436
US

IV. Provider business mailing address

PO BOX 6436
LEES SUMMIT MO
64064-6436
US

V. Phone/Fax

Practice location:
  • Phone: 816-301-4284
  • Fax:
Mailing address:
  • Phone: 816-301-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2011002854
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18319
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5139
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: