MEDICARE: MS. AMELIA GAIL CLAUSEN 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
1	1041C0700X	Clinical Social Worker	2003024039	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	30679017	OTHER	MO	BLUE CROSS BLUE SHIELD
3	SW003561	OTHER	MO	LCSW LICENSE

General Provider Information

NPI Number	:	1356372270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMELIA GAIL CLAUSEN LCSW

Provider Business Mailing Address
First Line	:	12102 OAK RIDGE RD
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64052-2824
Country	:	US
Telephone Number	:	816-473-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	12012 OAK RIDGE RD
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64052-2826
Country	:	US
Telephone Number	:	816-462-2953
Fax Number	:

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/25/2023

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