Provider Demographics
NPI:1114471679
Name:CLAVEY, CHARITY ANN (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:ANN
Last Name:CLAVEY
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:CLAVEY
Other - Last Name:HUMMELGAARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1555 NE RICE RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5849
Mailing Address - Country:US
Mailing Address - Phone:816-966-0900
Mailing Address - Fax:
Practice Address - Street 1:1579 NORTHEAST RICE ROAD
Practice Address - Street 2:
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5849
Practice Address - Country:US
Practice Address - Phone:816-966-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS724101Y00000X
KS4854104100000X
MO2018038645104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2018038645OtherLICENSE NUMBER