Healthcare Provider Details

I. General information

NPI: 1114807203
Provider Name (Legal Business Name): KORI RONGEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 EDMOND ST STE 203
SAINT JOSEPH MO
64501-2762
US

IV. Provider business mailing address

902 EDMOND ST STE 203
SAINT JOSEPH MO
64501-2762
US

V. Phone/Fax

Practice location:
  • Phone: 816-364-4300
  • Fax: 816-279-8148
Mailing address:
  • Phone: 816-364-4300
  • Fax: 816-279-8148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025038889
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: