MEDICARE: AMANDA MARIE ROSENBAUM-OUDE ALINK LSCSW, 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	104100000X	Social Worker	9175	KS
2	104100000X	Social Worker
3	1041C0700X	Clinical Social Worker	2018044949	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100098080C	OTHER	KS	SED WAIVER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912215864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE ROSENBAUM-OUDE ALINK LSCSW, LCSW

Provider Business Mailing Address
First Line	:	5108 NW 66TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-1949
Country	:	US
Telephone Number	:	166-545-8458
Fax Number	:

Provider Business Practice Location Address
First Line	:	5108 NW 66TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-1949
Country	:	US
Telephone Number	:	166-545-8458
Fax Number	:

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

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	12/04/2022

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