Individual provider Active NPI

Kevin Connaghan, LSCSW

  • Clinical Social Worker
  • Leawood, KS
National Provider Identifier
1033123963
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW 1687 Issued in KS
Practice address
4707 College Blvd
Suite 213
Leawood, KS 66211-1603
Phone
(913) 663-3000
Fax
(913) 663-1115
NPI assigned
Jul 28, 2006
Last updated
Nov 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSCSW 1687 KS Primary

Addresses

Primary practice location

4707 College Blvd
Suite 213
Leawood, KS 66211-1603

Mailing address

4707 College Blvd
Suite 213
Leawood, KS 66211-1603
Phone (913) 663-3000

Other identifiers 1

IdentifierTypeStateIssuer
100291030CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002371MOMDProfessional Counselor
LSCSW 1687KSMDClinical Social Worker
1687KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Teresa Varanka MD LLC PastSince Jun 1, 2001 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1033123963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 COLLEGE BLVD",
            "address_2": "SUITE 213",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111603",
            "telephone_number": "913-663-3000",
            "fax_number": "913-663-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 COLLEGE BLVD",
            "address_2": "SUITE 213",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111603",
            "telephone_number": "913-663-3000",
            "fax_number": "913-663-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNAGHAN",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW 1687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100291030C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.