=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699891267
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PHILIP R JONES LSCSW RAODAC LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8600 W 95TH ST SUITE 105
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-707-5532
-----------------------------------------------------
Fax | 913-894-1911
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 13434
-----------------------------------------------------
City | SHAWNEE MISSION
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66282-3434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-707-5532
-----------------------------------------------------
Fax | 913-894-1911
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 0276
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 000977
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------