Individual provider Active NPI

Anyssa J Wells, LSCSW

  • Clinical Social Worker
  • Overland Park, KS
National Provider Identifier
1972361988
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06196 Issued in KS
Practice address
11011 King St Ste 110
Overland Park, KS 66210-1230
Phone
(712) 299-4490
NPI assigned
Mar 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 06196 KS Primary

Addresses

Primary practice location

11011 King St Ste 110
Overland Park, KS 66210-1230

Mailing address

744 S Sumac St
Gardner, KS 66030-8109

Other practice location 1

744 S Sumac St
Gardner, KS 66030-8109
Phone (712) 299-4490

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

LicenseStateTypeSpecialty
06196KSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1972361988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S SUMAC ST",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660308109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 KING ST STE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101230",
            "telephone_number": "712-299-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Sumac St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "KS",
            "postal_code": "660308109",
            "country_code": "US",
            "telephone_number": "712-299-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "ANYSSA",
        "middle_name": "J",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.