Provider Demographics
NPI:1235216268
Name:STEEDE SPAULDING, CAROL J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:STEEDE SPAULDING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 WINNER ROAD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-0169
Mailing Address - Country:US
Mailing Address - Phone:816-254-3652
Mailing Address - Fax:816-254-9243
Practice Address - Street 1:10901 WINNER ROAD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-0169
Practice Address - Country:US
Practice Address - Phone:816-254-3652
Practice Address - Fax:816-254-9243
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0057471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29314028OtherBCBS OF KC
MO474D710AMedicare ID - Type Unspecified