Kristin Anne Coblentz Swan, LCSW
Individual provider Active NPI Clinical Social Worker · Raytown, MO
NPI 1407987662 · NPPES record last updated Dec 6, 2022
Key facts
- NPI
- 1407987662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2004032834 (MO)
- Practice address
- 7001 Blue Ridge Blvd
Raytown, MO 64133-5629 - Phone
- (816) 966-0900
- Fax
- (816) 347-3029
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3720 NE Troon Dr
Lees Summit, MO 64064-1988
Phone (816) 581-3737
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081120000557 | MO | Practitioner - Clinical Social Worker | 1557421542 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4902 | KS | MD | Social Worker |
| 2004032834 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swan Therapeutic Services, LLC | Clinical | Current |
Accepting new patients |
| Rediscover | Current |
Accepting new patients | |
| Rediscover | Current |
Accepting new patients |
Locations
1555 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3069
901 NE Independence Ave
Lees Summit, MO 64086
Phone (816) 246-1800
3720 NE Troon Dr
Lees Summit, MO 64064
Phone (816) 508-5934
529 SE 2nd St
Ste D
Lees Summit, MO 64063
Phone (816) 581-3737
7001 Blue Ridge Blvd
Raytown, MO 64133
Phone (816) 988-2739
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4902 | KS | |
| Clinical Social Worker | 1041C0700X | 2004032834 | MO | Yes |
Addresses
Primary practice location
7001 Blue Ridge Blvd
Raytown, MO 64133-5629
Mailing address
128 SE Somerset CT
Lees Summit, MO 64063-3626
Phone (816) 804-8847
Other practice location 1
529 SE 2nd St Ste D
Lees Summit, MO 64063-2654
Phone (816) 581-3737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 498735109 | Medicaid | MO |
Other providers in Raytown, MO
- Josiah Chumba
- City of Raytown
- Robin Morgan Clark
- Clear Consulting Group
- Sara Alison Clum
- Cole Vision Corporation
- Comfort Care Transportation LLC
- Community Support Partners
- Confidence Consumer Directed Services LLC
- Casey Cooper
All providers in Raytown, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.