Provider Demographics
NPI:1760773832
Name:STRODA, MELINDA J (MSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:J
Last Name:STRODA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9144 SCHWEIGER CT APT 148
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-2122
Mailing Address - Country:US
Mailing Address - Phone:913-707-5897
Mailing Address - Fax:
Practice Address - Street 1:8150 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5806
Practice Address - Country:US
Practice Address - Phone:816-508-3519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7855104100000X
MO2010017634104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker