Provider Demographics
NPI:1083757116
Name:KISER, ALICIA CHERI (MED)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:CHERI
Last Name:KISER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:CHERI
Other - Last Name:BECKMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:21504 W. 52ND STREET
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226
Mailing Address - Country:US
Mailing Address - Phone:913-744-0613
Mailing Address - Fax:
Practice Address - Street 1:400 E 6TH ST
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3703
Practice Address - Country:US
Practice Address - Phone:816-587-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006037234106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist