Active NPI
Charis Suzanne Pastor, LCSW
- Clinical Social Worker
- Independence, MO
National Provider Identifier
1154629467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2011004120
- Practice address
- 4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8312 - Phone
- (816) 373-9240
- NPI assigned
- Mar 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2011004120 | MO | Primary |
Addresses
Primary practice location
4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8312
Mailing address
3504 SE Adams Dr
Blue Springs, MO 64014-5458
Phone (816) 210-4881
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian a Fidler | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1154629467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3504 SE ADAMS DR",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640145458",
"telephone_number": "816-210-4881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 LITTLE BLUE PKWY",
"address_2": "SUITE 360",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640578312",
"telephone_number": "816-373-9240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTOR",
"first_name": "CHARIS",
"middle_name": "SUZANNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2011004120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.