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General NPI Number Information
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NPI Number | 1881182723
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Entity Type | Individual
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Provider Name | ERIKA O KOKORUDA LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 5808 W 110TH ST
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City | OVERLAND PARK
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State | KS
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Zip | 66211-2504
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Country | US
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Telephone | 913-696-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 GILLHAM RD. PROVIDER ENROLLMENT
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 816-701-5200
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Fax | 816-302-9939
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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 | 9051
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License Number State | KS
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