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NPI 1952909913

NPI 1952909913 : ERICA L MAGSAM : KANSAS CITY, KS

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General NPI Number Information
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    NPI Number           |    1952909913
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    Entity Type          |    Individual 
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    Provider Name        |    ERICA L MAGSAM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/13/2020
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    Last Update Date     |    10/26/2022
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Provider Practice Location Address
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    Address Line         |    4000 CAMBRIDGE ST 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66160-8501
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    Country              |    US
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    Telephone            |    913-588-1227
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4000 CAMBRIDGE ST 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66160-8102
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    Country              |    US
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    Telephone            |    913-588-1227
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    12252
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    License Number State |    NE
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    03063
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    License Number State |    KS
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