Alicia M Landsverk, PHD, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1527 Issued in KS

Practice address

1721 E Osage Rd
Ste 300
Derby, KS 67037-2092

Phone

(316) 788-1907

Fax

(316) 788-1941

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1972507457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E OSAGE RD STE 300",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372290",
            "telephone_number": "316-788-1907",
            "fax_number": "316-788-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E OSAGE RD",
            "address_2": "STE 300",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372092",
            "telephone_number": "316-788-1907",
            "fax_number": "316-788-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSVERK",
        "first_name": "ALICIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD, LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004880B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shonda L Kooser, T-MFT 03519-T
• Heather Korntheuer, CPTA
• Hai Minh Koulaboud, PHARM D.
• Alexandra Krisik
• Chantel Lambert, OTR/L
• Mahleah Lavin, MT-BC
• Huyen Susan Le
• Tan Viet Le, PHARM.D
• Tina Le, APRN
• Angela N Lentz, PHARM.D

• Clinical Social Worker in Derby, KS
• Providers in Derby, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.