Provider Demographics
NPI:1598045528
Name:SUTHERLAND, MARGOT MAE (LMSW)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:MAE
Last Name:SUTHERLAND
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 1:1223 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1258
Mailing Address - Country:US
Mailing Address - Phone:816-853-3145
Mailing Address - Fax:
Practice Address - Street 1:1223 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1258
Practice Address - Country:US
Practice Address - Phone:816-853-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker