Healthcare Provider Details

I. General information

NPI: 1164168910
Provider Name (Legal Business Name): OLIVIA KAUFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W KANSAS ST
LIBERTY MO
64068-2343
US

IV. Provider business mailing address

7417 N BOOTH AVE
KANSAS CITY MO
64158-1263
US

V. Phone/Fax

Practice location:
  • Phone: 816-226-7397
  • Fax:
Mailing address:
  • Phone: 816-695-5573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: