MEDICARE: DR. ASHLEY N CLAUSEN PHD

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	103T00000X	Psychologist	3571	MT
2	103TC0700X	Clinical Psychologist	5626	NC
3	103TC0700X	Clinical Psychologist	2022036455	MO

General Provider Information

NPI Number	:	1477194900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY N CLAUSEN PHD

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400S
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:	816-932-1719

Provider Business Practice Location Address
First Line	:	4400 BROADWAY BLVD STE 316
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3305
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:

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

Provider Enumeration Date	:	10/07/2019
Last Update Date	:	12/21/2022

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