Individual provider Active NPI

Eva Elaine Husted, LSCSW/LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1770574477
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004654 Issued in MO
Practice address
10323 N Tracy Ave
Kansas City, MO 64155-1994
Phone
(816) 260-0250
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 2164 KS
Clinical Social Worker 1041C0700X 004654 MO Primary

Addresses

Primary practice location

10323 N Tracy Ave
Kansas City, MO 64155-1994

Mailing address

10323 N Tracy Ave
Kansas City, MO 64155-1994
Phone (816) 734-7104

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004654MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
BPH LLC Past Accepting new patients
John T Bopp PC Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1770574477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10323 N TRACY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641551994",
            "telephone_number": "816-734-7104",
            "fax_number": "816-734-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10323 N TRACY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641551994",
            "telephone_number": "816-260-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTED",
        "first_name": "EVA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LSCSW/LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "2164",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.