Tiffany R Sturdivant, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2008026544 Issued in MO

Practice address

300 W 19TH Ter
Kansas City, MO 64108-2026

Phone

(816) 404-5755

Fax

(816) 404-5751

NPI assigned

May 15, 2008

Last updated

Dec 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1871760082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 PROSPECT AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641272544",
            "telephone_number": "816-404-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 19TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082026",
            "telephone_number": "816-404-5755",
            "fax_number": "816-404-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641272544",
            "country_code": "US",
            "telephone_number": "816-404-5752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2008026544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494074602",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Alan Stull, DC
• Keenan Stump, SLP
• Christopher Joel Stunz, CPO
• Mikayla Renee Stupps, MOT
• Robert B Sturdevant, D.O
• Zachary Sturm, PTA
• Lua Stutzer, RN
• Ashtyn Stutzman, DO
• Amanda Lynn Styers, APRN
• Tim Suarez

• 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 Dec 22, 2020; 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.