Provider Demographics
NPI:1407197981
Name:MCCAFFREY, MICKI D (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MICKI
Middle Name:D
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:D
Other - Last Name:MCCAFFREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:4801 E LINWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128-2226
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:861-922-4644
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:861-922-4644
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker