Organization
JUDY C FUNK LSCW CLINICAL SOCIAL WORK LLC
Active
Organization
JUDY C FUNK LSCW CLINICAL SOCIAL WORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY C FUNK LCSW (OWNER)
(913) 980-4975
Entity
Organization
Contact information
Practice address
5103 SW SURF SCOOTER ST, LEES SUMMIT, MO 64082-4599
(816) 509-4211
Mailing address
10042 KNOX DR, OVERLAND PARK, KS 66212-5339
(913) 980-4975
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
200903697
MO
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
200903697
MO
311ZA0620X
Adult Care Home Facility
200903697
MO
320700000X
Physical Disabilities Residential Treatment Facility
200903697
MO
Other
Enumeration date
08/26/2010
Last updated
08/27/2010
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