Jag Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000712 Issued in MO

Legal business name

JAG THERAPY, LLC

Practice address

4401 N.E. Vivion Rd
Suite 203
Kansas City, MO 64119-2800

Phone

(816) 455-7450

NPI assigned

Jun 7, 2006

Last updated

Sep 24, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Julie A Gibson, M.S.W.NPI 1700073202

Title

Manager/ Therapist

Phone

(816) 455-7450

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Ann Gibson, MSW, LCSW

  • Clinical Social Worker
  • Kansas City, MO
  • NPI 1700073202
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1831139104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N.E. VIVION RD",
            "address_2": "SUITE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641192800",
            "telephone_number": "816-455-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 N.E. VIVION RD",
            "address_2": "SUITE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641192800",
            "telephone_number": "816-455-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER/ THERAPIST",
        "authorized_official_telephone_number": "816-455-7450",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "000712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla J Jacquinot, P.T.
• Kavita Kondiba Jadhav, M.D.
• Mukund Jadhav, R.N.
• David Jaffe
• Syed Faisal Jafri, MD
• Farahnaz Jahangirian, PHARM.D.
• Badal G. Jain, MD
• Deborah A. Jaklevic, MSN, APRN, NP-C
• Andre Miklos Jakoi, M.D.
• Jaleel's Hands

• Clinical Social Worker in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.