Active NPI
Susan Lynn Peach, LCSW
- Clinical Social Worker
- Independence, MO
National Provider Identifier
1205964970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005220
- Practice address
- 3210 S Lees Summit Rd
Independence, MO 64055-1943 - Phone
- (816) 836-2920
- Fax
- (816) 836-2923
- NPI assigned
- Mar 2, 2007
- 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 | 005220 | MO | Primary |
Addresses
Primary practice location
3210 S Lees Summit Rd
Independence, MO 64055-1943
Mailing address
8806 W 49TH Ter
Merriam, KS 66203-1712
Phone (913) 432-6297
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005220 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeworks Family Treatment Group, LLC | 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.
-
- Clinical Social Worker
- Merriam, KS
- NPI 1700920923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205964970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8806 W 49TH TER",
"city": "MERRIAM",
"state": "KS",
"postal_code": "662031712",
"telephone_number": "913-432-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3210 S LEES SUMMIT RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640551943",
"telephone_number": "816-836-2920",
"fax_number": "816-836-2923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACH",
"first_name": "SUSAN",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "005220",
"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 Jul 9, 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.