MEDICARE: CYRI KRANTZ LSCWS, LCSW, LCAC

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	1041C0700X	Clinical Social Worker	2011032483	MO
2	1041C0700X	Clinical Social Worker	4075	KS

General Provider Information

NPI Number	:	1255112140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYRI KRANTZ LSCWS, LCSW, LCAC

Provider Business Mailing Address
First Line	:	12310 GRANADA LN
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66209-2635
Country	:	US
Telephone Number	:	816-509-1955
Fax Number	:

Provider Business Practice Location Address
First Line	:	12310 GRANADA LN
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66209-2635
Country	:	US
Telephone Number	:	816-509-1955
Fax Number	:

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

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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