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NPI Code Detail

MEDICARE: PATRICIA L MARTELL LCSW

MEDICARE:   PATRICIA L MARTELL  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
11041C0700XClinical Social WorkerSW003342MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127228051OTHERMOBLUE CROSS BLUE SHIELD OF KANSAS CITY

General Provider Information

NPI Number : 1346270378
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA L MARTELL LCSW
Provider Business Mailing Address
First Line : 420 E 73RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-1621
Country : US
Telephone Number : 816-401-4976
Fax Number :
Provider Business Practice Location Address
First Line : 8016 STATE LINE RD STE 205
Second Line :
City : PRAIRIE VILLAGE
State : KS
Zip : 66208-3713
Country : US
Telephone Number : 816-401-4976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 04/07/2021

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Directions to “ PATRICIA L MARTELL LCSW” Practice Location

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