Healthcare Provider Details

I. General information

NPI: 1912380635
Provider Name (Legal Business Name): DAVID ROWLAND MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 VILLAGE DR GARDEN LEVEL 30
SAINT JOSEPH MO
64506-4979
US

IV. Provider business mailing address

3500 VILLAGE DR GARDEN LEVEL 30
SAINT JOSEPH MO
64506-4979
US

V. Phone/Fax

Practice location:
  • Phone: 816-424-6530
  • Fax:
Mailing address:
  • Phone: 816-424-6530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2015021261
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2017039593
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: