Provider Demographics
NPI:1033872650
Name:HANSARD, SHELBY DAWN (LCSW, LSCSW)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:DAWN
Last Name:HANSARD
Suffix:
Gender:F
Credentials:LCSW, LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8923 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-1606
Mailing Address - Country:US
Mailing Address - Phone:316-304-9400
Mailing Address - Fax:
Practice Address - Street 1:8923 E 79TH ST
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-1606
Practice Address - Country:US
Practice Address - Phone:816-366-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS054081041C0700X
MO20190438021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical