Provider Demographics
NPI:1093334286
Name:DRUM, DAVID (LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DRUM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33989 W 90TH CIR
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:KS
Mailing Address - Zip Code:66018-8601
Mailing Address - Country:US
Mailing Address - Phone:913-269-4477
Mailing Address - Fax:
Practice Address - Street 1:6331 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1509
Practice Address - Country:US
Practice Address - Phone:913-696-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1631101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)