Individual
KELLY D ADKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5001 LAKE AVE, SAINT JOSEPH, MO 64504-1170
(816) 238-7788
(816) 238-9298
Mailing address
724 N 22ND ST, SAINT JOSEPH, MO 64506-2604
(816) 261-4939
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2017017986
MO
1041C0700X
Clinical Social Worker
Primary
2020000664
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490066457
—
MO
Enumeration date
10/02/2017
Last updated
11/10/2021
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