Provider Demographics
NPI:1407072333
Name:GUILLEN, ADRIANNE (LCSW, LSCSW)
Entity Type:Individual
Prefix:MS
First Name:ADRIANNE
Middle Name:
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:LCSW, LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 JARBOE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-3518
Mailing Address - Country:US
Mailing Address - Phone:816-678-7128
Mailing Address - Fax:
Practice Address - Street 1:1703 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-4328
Practice Address - Country:US
Practice Address - Phone:816-678-7128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0057241041C0700X
KS17001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical