Individual provider Active NPI

Renee Rolfs-Radke, LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1275045114
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2016011857 Issued in MO
Practice address
9601 NE Barry Rd Ste 220
Kansas City, MO 64158-1124
Phone
(816) 416-2333
NPI assigned
Nov 1, 2017
Last updated
Nov 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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 2016011857 MO Primary

Addresses

Primary practice location

9601 NE Barry Rd Ste 220
Kansas City, MO 64158-1124

Mailing address

10107 N Chestnut CT
Kansas City, MO 64155-8909
Phone (586) 855-8057

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
2016011857MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1275045114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10107 N CHESTNUT CT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641558909",
            "telephone_number": "586-855-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 NE BARRY RD STE 220",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581124",
            "telephone_number": "816-416-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLFS-RADKE",
        "first_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016011857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.