Provider Demographics
NPI:1437264017
Name:EBERT, CHRISTINA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:EBERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 NW 78TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-1456
Mailing Address - Country:US
Mailing Address - Phone:816-813-9886
Mailing Address - Fax:816-436-0602
Practice Address - Street 1:21 NW 78TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-1456
Practice Address - Country:US
Practice Address - Phone:816-813-9886
Practice Address - Fax:816-436-0602
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6471104100000X
MO20110082741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker