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Individual

MICHAEL GRANOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
4200 SOMERSET DR, STE 254, PRAIRIE VILLAGE, KS 66208-5213
(913) 677-2277
(913) 491-8448
Mailing address
4350 SHAWNEE MISSION PKWY, SUITE 252, FAIRWAY, KS 66205
(913) 677-2277
(913) 677-2229

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
006065
MO
1041C0700X
Clinical Social Worker
Primary
1241
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200400620A
KS
01
29164021
BCBS OF KC
Enumeration date
12/08/2006
Last updated
10/12/2016
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