Individual provider Active NPI

Jennifer Dawdy, LSCSW

  • Clinical Social Worker
  • Kansas City, KS
National Provider Identifier
1043459068
Registry record updated Feb 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3788 Issued in KS
Practice address
630 Minnesota Ave Ste 208
Kansas City, KS 66101-2850
Phone
(913) 544-4877
NPI assigned
Feb 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X KS
Clinical Social Worker 1041C0700X 3788 KS Primary

Addresses

Primary practice location

630 Minnesota Ave Ste 208
Kansas City, KS 66101-2850

Mailing address

PO Box 171127
Kansas City, KS 66117-0127
Phone (913) 544-5877

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3788KSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234569600000",
    "number": "1043459068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171127",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661170127",
            "telephone_number": "913-544-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MINNESOTA AVE STE 208",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661012850",
            "telephone_number": "913-544-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWDY",
        "first_name": "JENNIFER",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-14",
        "last_updated": "2009-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2009; 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.