Individual
KELLY R. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 N SUNSET LN, RAYMORE, MO 64083-6408
(844) 853-8937
Mailing address
3801 BLUE PKWY, KANSAS CITY, MO 64130-2807
(816) 599-5267
(816) 599-5951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2020018075
MO
1041C0700X
Clinical Social Worker
Primary
2025018371
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020018075
STATE LICENSE
MO
Enumeration date
10/06/2020
Last updated
05/28/2025
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