Provider Demographics
NPI:1124221742
Name:FLOYD, RANDY BRENT (LSCSW)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:BRENT
Last Name:FLOYD
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 W 110TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1868
Mailing Address - Country:US
Mailing Address - Phone:913-226-9888
Mailing Address - Fax:913-397-7421
Practice Address - Street 1:8575 W 110TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1868
Practice Address - Country:US
Practice Address - Phone:913-226-9888
Practice Address - Fax:913-397-7421
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS38731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical