Provider Demographics
NPI:1609409804
Name:VIVEROS-SCHMIDT, ANASTASIA (LMSW)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:VIVEROS-SCHMIDT
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 1:4031 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2207
Mailing Address - Country:US
Mailing Address - Phone:913-626-1018
Mailing Address - Fax:
Practice Address - Street 1:4031 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2207
Practice Address - Country:US
Practice Address - Phone:913-626-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-16
Last Update Date:2020-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6752104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker