MEDICARE: PAIGE THRELKELD LSCSW

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	2022047971	MO
2	1041C0700X	Clinical Social Worker	05815	KS

General Provider Information

NPI Number	:	1275984874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE THRELKELD LSCSW

Provider Business Mailing Address
First Line	:	13651 S MUR LEN RD
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1648
Country	:	US
Telephone Number	:	913-971-0842
Fax Number	:

Provider Business Practice Location Address
First Line	:	13651 S MUR LEN RD
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1648
Country	:	US
Telephone Number	:	913-971-0842
Fax Number	:

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

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	06/27/2025

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