Provider Demographics
NPI:1245427954
Name:GIRALDO, MAUREEN GRAHAM (LCSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:GRAHAM
Last Name:GIRALDO
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 1:436 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-1620
Mailing Address - Country:US
Mailing Address - Phone:702-686-1530
Mailing Address - Fax:
Practice Address - Street 1:9601 NE BARRY RD STE 220
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158
Practice Address - Country:US
Practice Address - Phone:816-415-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5658-C1041C0700X
KS45921041C0700X
MO20160303211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical