Organization
LCSW, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA L MARTELL LCSW (PRESIDENT)
(816) 401-4976
Entity
Organization
Contact information
Practice address
12600 E 40 HWY, INDEPENDENCE, MO 64055-5955
(816) 753-3333
(816) 478-8888
Mailing address
420 E 73RD ST, KANSAS CITY, MO 64131-1621
(816) 361-3019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003342
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346270378
—
MO
Enumeration date
04/16/2010
Last updated
04/16/2010
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