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Individual

MR. JAMY DEAN VANSYCKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3101 BROADWAY BLVD, KANSAS CITY, MO 64111-2659
(816) 302-3700
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2010011399
MO

Other

Enumeration date
10/14/2010
Last updated
09/23/2024
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