Matthew James Atwood, PHD, LCSW
Individual provider Active NPI Clinical Social Worker · Leavenworth, KS
NPI 1386849024 · NPPES record last updated Aug 26, 2024
Key facts
- NPI
- 1386849024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2017014248 (MO)
- Practice address
- 4101 S 4TH St BLDG 160
Leavenworth, KS 66048-5014 - Phone
- (913) 682-2000
- NPI assigned
- Jun 20, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017014248 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2017014248 | MO | Yes |
Addresses
Primary practice location
4101 S 4TH St BLDG 160
Leavenworth, KS 66048-5014
Mailing address
1143 Holman St
Leavenworth, KS 66048-4223
Phone (913) 297-4687
Other providers in Leavenworth, KS
- Charles Andrew Ashley
- Jaynell Kay Assmann
- Atchison Community Health Clinic Inc
- Atchison Home Health Equipment, Inc
- William R Atchison II
- Alexandria Austin
- Barbara Joyce Austin
- Autism, Behavior, and Psychological Services
- Christine Bachtel
- Joni L. Baeke-Hartong
All providers in Leavenworth, KS · Clinical Social Worker in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.