Provider Demographics
NPI:1376968511
Name:TATE, AUKEYSIA R (LCSW)
Entity Type:Individual
Prefix:
First Name:AUKEYSIA
Middle Name:R
Last Name:TATE
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 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-767-4346
Mailing Address - Fax:
Practice Address - Street 1:10918 ELM AVE STE 102
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-2284
Practice Address - Country:US
Practice Address - Phone:816-767-4346
Practice Address - Fax:808-691-7896
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200303721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical