Provider Demographics
NPI:1487859971
Name:ALTSCHUL, DAVID B (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:ALTSCHUL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-1629
Mailing Address - Country:US
Mailing Address - Phone:816-588-3038
Mailing Address - Fax:816-931-0142
Practice Address - Street 1:3101 TROOST AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-1845
Practice Address - Country:US
Practice Address - Phone:816-931-4751
Practice Address - Fax:816-931-0142
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070003971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical