Active NPI
Annalissa Brodersen, LMSW
- Social Worker
- Lenexa, KS
National Provider Identifier
1821844481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW13635
- Practice address
- 16979 W 94TH St Ste D
Lenexa, KS 66219-1939 - Phone
- (913) 353-8191
- NPI assigned
- Apr 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW13635 | KS | Primary |
Addresses
Primary practice location
16979 W 94TH St Ste D
Lenexa, KS 66219-1939
Mailing address
16979 W 94TH St Ste D
Lenexa, KS 66219-1939
Phone (913) 353-8191
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW13635 | KS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1821844481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16979 W 94TH ST STE D",
"city": "LENEXA",
"state": "KS",
"postal_code": "662191939",
"telephone_number": "913-353-8191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16979 W 94TH ST STE D",
"city": "LENEXA",
"state": "KS",
"postal_code": "662191939",
"telephone_number": "913-353-8191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERSEN",
"first_name": "ANNALISSA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-25",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "LMSW13635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lenexa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.