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General NPI Number Information
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NPI Number | 1518486075
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Entity Type | Individual
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Provider Name | MICHAEL WIEBERG LCSW, LSCSW
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Gender | Male
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 7199 W 98TH TER STE 130
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City | OVERLAND PARK
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State | KS
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Zip | 66212-6158
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Country | US
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Telephone | 913-294-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 FLINTROCK ST
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City | KEARNEY
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State | MO
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Zip | 64060-9408
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Country | US
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Telephone | 816-304-6215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2015020805
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2018012929
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License Number State | MO
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