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General NPI Number Information
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NPI Number | 1376763516
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF KANSAS CITY-ST. JOSEPH, INC.
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 902 EDMOND ST STE 204
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-2762
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Country | US
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Telephone | 816-232-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 2816 CHARLES ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-3339
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Country | US
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Telephone | 816-233-1324
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | JAN SMITH
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Credential | LCSW
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Telephone | 816-232-2885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4307
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License Number State | MO
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