Individual
ELLEN T WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1800 COMMUNITY, CLINTON, MO 64735-8804
(816) 728-3650
Mailing address
32204 E OAKLAND SCHOOL RD, BUCKNER, MO 64016-7106
(816) 517-8362
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
915
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30501014
BLUE CROSS BLUE SHIELD
MO
01
—
31543
NEW DIRECTIONS
MO
05
—
496905613
—
MO
Enumeration date
08/31/2006
Last updated
11/05/2012
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