Individual provider Active NPI

Sue Laura Severance, MSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1306997010
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004593 Issued in MO
Practice address
5904 E Bannister Rd
Kansas City, MO 64134-1141
Phone
(816) 966-0900
Fax
(816) 347-3209
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2420 KS
Clinical Social Worker 1041C0700X 004593 MO Primary

Addresses

Primary practice location

5904 E Bannister Rd
Kansas City, MO 64134-1141

Mailing address

1555 NE Rice Rd
Lees Summit, MO 64086-5849
Phone (816) 966-0900

Other identifiers 2

IdentifierTypeStateIssuer
100098080AMedicaidKS
100098080COtherKSSED WAIVER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131115001752 MO Practitioner - Clinical Social Worker 6507857851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RediscoverGroup PAC ID 3375453517, 50 clinicians

Practice addresses (Care Compare)

1535 NE Rice Rd
Lees Summit, MO 64086-5849
Phone (816) 246-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004593MOMDClinical Social Worker
2420KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rediscover CurrentSince Oct 24, 2016 Accepting new patients
Rediscover CurrentSince Oct 24, 2016 Accepting new patients

Locations

5904 E Bannister Rd
Kansas City, MO 64134
Phone (816) 966-0903

1535 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3258

1555 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3069

901 NE Independence Ave
Lees Summit, MO 64086
Phone (816) 246-1800

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1306997010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-966-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 E BANNISTER RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641341141",
            "telephone_number": "816-966-0900",
            "fax_number": "816-347-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERANCE",
        "first_name": "SUE",
        "middle_name": "LAURA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "2420",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098080A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SED WAIVER",
            "identifier": "100098080C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.