1003977729 NPI number — DR. MARSHA R READ MSW PHD

Table of content: DR. MARSHA R READ MSW PHD (NPI 1003977729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003977729 NPI number — DR. MARSHA R READ MSW PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
READ
Provider First Name:
MARSHA
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MSW PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003977729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 NICHOLS RD
Provider Second Line Business Mailing Address:
SUITE 217
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-931-9912
Provider Business Mailing Address Fax Number:
816-561-5352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12231 CHARLOTTE ST
Provider Second Line Business Practice Location Address:
SUITE 217
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64146-1108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-931-9912
Provider Business Practice Location Address Fax Number:
816-561-5352
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  2002010278 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20185035 . This is a "BCBS RC" identifier . This identifiers is of the category "OTHER".




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