Provider Demographics
NPI:1457823015
Name:GABBERT, MICHELLE DENISE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DENISE
Last Name:GABBERT
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 1:7812 ASH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4742
Mailing Address - Country:US
Mailing Address - Phone:913-485-4379
Mailing Address - Fax:
Practice Address - Street 1:2708 W 43RD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3125
Practice Address - Country:US
Practice Address - Phone:913-708-8247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS87501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical