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General NPI Number Information
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NPI Number | 1932238490
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Entity Type | Individual
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Provider Name | JACQUELINE ANITA HOGAN LSCSW,LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 753 STATE AVE SUITE 660
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City | KANSAS CITY
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State | KS
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Zip | 66101-2516
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Country | US
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Telephone | 913-244-8443
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Fax |
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Provider Business Mailing Address
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Address Line | 2326 N 43RD TER
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City | KANSAS CITY
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State | KS
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Zip | 66104-3424
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2002016074
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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 | 2264
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License Number State | KS
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