Provider Demographics
NPI:1467597088
Name:HALL, KERRI JO (LSCSW)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:JO
Last Name:HALL
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 1:7700 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3078
Mailing Address - Country:US
Mailing Address - Phone:913-558-5648
Mailing Address - Fax:913-262-6574
Practice Address - Street 1:7700 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 214
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-3078
Practice Address - Country:US
Practice Address - Phone:913-558-5648
Practice Address - Fax:913-262-6574
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical