MEDICARE: MARY CUTTING 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	SW000245	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27455021	OTHER	MO	BC/BS KC

General Provider Information

NPI Number	:	1861426892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CUTTING LCSW

Provider Business Mailing Address
First Line	:	4901 MAIN ST
Second Line	:	STE. 401
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2646
Country	:	US
Telephone Number	:	816-753-7071
Fax Number	:	816-753-8189

Provider Business Practice Location Address
First Line	:	4901 MAIN ST
Second Line	:	STE. 401
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2646
Country	:	US
Telephone Number	:	816-753-7071
Fax Number	:	816-753-8189

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

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