Provider Demographics
NPI:1609000256
Name:SPEAR, AUDREY BETH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:BETH
Last Name:SPEAR
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:913-890-7500
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:913-890-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7390104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker