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NPI Code Detail

MEDICARE: MS. KATHLEEN A BOLT LSCSW

MEDICARE:  MS. KATHLEEN A BOLT  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
11041C0700XClinical Social WorkerLSCSW1048KS

General Provider Information

NPI Number : 1578797742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN A BOLT LSCSW
Provider Business Mailing Address
First Line : 9218 METCALF AVE
Second Line : A333
City : OVERLAND PARK
State : KS
Zip : 66212-1476
Country : US
Telephone Number : 785-393-0215
Fax Number :
Provider Business Practice Location Address
First Line : 9319 DEARBORN ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66207-2421
Country : US
Telephone Number : 785-393-0215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2009
Last Update Date : 05/04/2009

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Directions to “ MS. KATHLEEN A BOLT LSCSW” Practice Location

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