Individual provider Active NPI

Bernadette Elena Borchardt, LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1649587148
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2013003118 Issued in MO
Practice address
4635 Wyandotte St
Suite 204
Kansas City, MO 64112-1509
Phone
(816) 398-7858
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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 2013003118 MO Primary

Addresses

Primary practice location

4635 Wyandotte St
Suite 204
Kansas City, MO 64112-1509

Mailing address

4635 Wyandotte St
Suite 204
Kansas City, MO 64112-1509
Phone (816) 398-7858

Other identifiers 1

IdentifierTypeStateIssuer
1649587148MedicaidMO

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
I20160622001992 MO Practitioner - Clinical Social Worker 7719278795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Therapy LLCGroup PAC ID 8729379797, 2 clinicians

Practice addresses (Care Compare)

4635 Wyandotte St
Suite 204
Kansas City, MO 64112-1502
Phone (816) 599-3918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Therapy, LLC Clinical CurrentSince Apr 15, 2016 Accepting new patients

Locations

4635 Wyandotte St
Ste 204
Kansas City, MO 64112
Phone (816) 599-3918

4635 Wyandotte St
Kansas City, MO 64112

660 SE Bayberry Ln
Ste 105
Lees Summit, MO 64063
Phone (816) 599-3918

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1649587148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 WYANDOTTE ST",
            "address_2": "SUITE 204",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121509",
            "telephone_number": "816-398-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 WYANDOTTE ST",
            "address_2": "SUITE 204",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121509",
            "telephone_number": "816-398-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCHARDT",
        "first_name": "BERNADETTE",
        "middle_name": "ELENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013003118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649587148",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.