Individual
KELSEY J SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 689-2133
Mailing address
1407 NE 119TH TER, KANSAS CITY, MO 64155-2460
(816) 284-9344
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9156
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10098080A
—
KS
01
—
10098080C
SED WAIVER
KS
Enumeration date
06/17/2014
Last updated
06/17/2014
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