MEDICARE: CATHOLIC CHARITIES OF NORTHEAST KANSAS INC

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

General Provider Information

NPI Number	:	1902979875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES OF NORTHEAST KANSAS INC

Provider Business Mailing Address
First Line	:	9720 W 87TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66212-4563
Country	:	US
Telephone Number	:	913-433-2100
Fax Number	:	913-433-2101

Provider Business Practice Location Address
First Line	:	600 MINNESOTA AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66101-2806
Country	:	US
Telephone Number	:	913-621-1504
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	LAUREN SOLIDUM
Credential	:
Telephone Number	:	913-433-2100

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	11/20/2025

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