Individual
MRS. KELLY LYNN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7900 LEES SUMMIT RD, KANSAS CITY, MO 64139-1236
(816) 404-9389
(816) 404-9516
Mailing address
PO BOX 844, BLUE SPRINGS, MO 64013
(816) 797-3783
(816) 220-9682
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
004820
MO
1041C0700X
Clinical Social Worker
Primary
SW 004820
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498554401
—
MO
Enumeration date
12/13/2006
Last updated
11/19/2020
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