Provider Demographics
NPI:1245559814
Name:NELSON-JOHNS, SARA (LCSW, LMSW, MSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:NELSON-JOHNS
Suffix:
Gender:F
Credentials:LCSW, LMSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 WASHINGTON ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2609
Mailing Address - Country:US
Mailing Address - Phone:913-735-7161
Mailing Address - Fax:
Practice Address - Street 1:4010 WASHINGTON ST
Practice Address - Street 2:SUITE 405
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2609
Practice Address - Country:US
Practice Address - Phone:913-735-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060393421041C0700X
KS59621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical