Provider Demographics
NPI:1427405117
Name:CANNADY, LISA (LSCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CANNADY
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 N SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5976
Mailing Address - Country:US
Mailing Address - Phone:913-353-9020
Mailing Address - Fax:913-353-9020
Practice Address - Street 1:25955 W 327TH ST
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-4920
Practice Address - Country:US
Practice Address - Phone:913-557-9096
Practice Address - Fax:913-294-9247
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLCSW 20150257951041C0700X
KSLSCSW 44061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical