MEDICARE: DR. MARSHA R READ MSW PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	2002010278	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20185035	OTHER		BCBS RC

General Provider Information

NPI Number	:	1003977729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHA R READ MSW PHD

Provider Business Mailing Address
First Line	:	411 NICHOLS RD
Second Line	:	SUITE 217
City	:	KANSAS CITY
State	:	MO
Zip	:	64112
Country	:	US
Telephone Number	:	816-931-9912
Fax Number	:	816-561-5352

Provider Business Practice Location Address
First Line	:	12231 CHARLOTTE ST
Second Line	:	SUITE 217
City	:	KANSAS CITY
State	:	MO
Zip	:	64146-1108
Country	:	US
Telephone Number	:	816-931-9912
Fax Number	:	816-561-5352

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	10/12/2016

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