Individual
MS. LISA A BLUME SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW,LCSW
Contact information
Practice address
2633 INDEPENDENCE AVE, KANSAS CITY, MO 64124-2433
(816) 743-9911
Mailing address
2633 INDEPENDENCE AVE, KANSAS CITY, MO 64124-2433
(816) 743-9911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1898
KS
1041C0700X
Clinical Social Worker
Primary
2000161360
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
395D084
MEDICARE PROVIDER
—
Enumeration date
09/28/2007
Last updated
06/05/2008
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