MEDICARE: MISS STEPHANIE ANNE ELLIOTT MSW, 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	LSCSW06133	KS

General Provider Information

NPI Number	:	1821385048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS STEPHANIE ANNE ELLIOTT MSW, LSCSW

Provider Business Mailing Address
First Line	:	7500 W 160TH ST STE 100
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8100
Country	:	US
Telephone Number	:	913-404-5232
Fax Number	:	913-423-1230

Provider Business Practice Location Address
First Line	:	7500 W 160TH ST STE 100
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-8100
Country	:	US
Telephone Number	:	913-404-5232
Fax Number	:	913-423-1230

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

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	04/05/2024

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