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General NPI Number Information
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NPI Number | 1790767218
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Entity Type | Individual
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Provider Name | RICHARD CHARLES ARCHER LSCSW
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4400 BROADWAY STE 520
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City | KANSAS CITY
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State | MO
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Zip | 64111-3342
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Country | US
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Telephone | 816-960-7600
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Fax | 816-960-7699
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Provider Business Mailing Address
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Address Line | 901 E 104TH ST MAILSTOP 400S
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City | KANSAS CITY
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State | MO
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Zip | 64131
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Country | US
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Telephone | 816-502-7117
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Fax | 816-932-9670
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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 | 1170
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License Number State | KS
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