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NPI Code Detail

MEDICARE: MS. JENNIFER DAWN NEWCOMER LCSW

MEDICARE:  MS. JENNIFER DAWN NEWCOMER  LCSW
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCADC1 (PENDING)KS
2104100000XSocial Worker2156KS
3104100000XSocial Worker2000168346MO
41041C0700XClinical Social Worker2000168346MO

General Provider Information

NPI Number : 1174510580
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER DAWN NEWCOMER LCSW
Provider Business Mailing Address
First Line : 4602 NE 83RD TER
Second Line :
City : KANSAS CITY
State : MO
Zip : 64119-7617
Country : US
Telephone Number : 816-529-5990
Fax Number :
Provider Business Practice Location Address
First Line : 5775 NW 64TH TER
Second Line : STE. 202
City : KANSAS CITY
State : MO
Zip : 64151-2382
Country : US
Telephone Number : 816-505-3333
Fax Number : 816-753-7744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 12/15/2014

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Directions to “ MS. JENNIFER DAWN NEWCOMER LCSW” Practice Location

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