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General NPI Number Information
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NPI Number | 1750861548
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Entity Type | Individual
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Provider Name | CHARLENE MICHELLE NIEDENS L.S.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 4350 SHAWNEE MISSION PKWY STE 1200
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City | FAIRWAY
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State | KS
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Zip | 66205-2528
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Country | US
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Telephone | 913-945-7310
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Fax | 913-945-7563
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Provider Business Mailing Address
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Address Line | 4350 SHAWNEE MISSION PKWY STE 1200
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City | FAIRWAY
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State | KS
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Zip | 66205-2528
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Country | US
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Telephone | 913-945-7310
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Fax | 913-945-7563
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1923
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License Number State | KS
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