Heather Drake, LSCSW

Individual provider Active NPI Clinical Social Worker · Fairway, KS

NPI 1497200968 · NPPES record last updated Aug 24, 2016

Key facts

NPI
1497200968
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LSCSW #1453 (KS)
Practice address
5231 Aberdeen Rd
Fairway, KS 66205-1728
Phone
(913) 269-1748
NPI assigned
Aug 24, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CRAADC #1476MOMDAddiction (Substance Use Disorder) Counselor
LSCSW #1453KSMDClinical Social Worker
LCSW #004458MOMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CRAADC #1476 MO
Clinical Social Worker 1041C0700X LSCSW #1453 KS Yes
Clinical Social Worker 1041C0700X LCSW #004458 MO

Addresses

Primary practice location

5231 Aberdeen Rd
Fairway, KS 66205-1728

Mailing address

5231 Aberdeen Rd
Fairway, KS 66205-1728
Phone (913) 269-1748

Other providers in Fairway, KS

All providers in Fairway, KS · Clinical Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.