Provider Demographics
NPI:1790829299
Name:LANDREGAN, JOHN SCOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SCOTT
Last Name:LANDREGAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64127-1321
Mailing Address - Country:US
Mailing Address - Phone:816-965-1100
Mailing Address - Fax:816-965-1140
Practice Address - Street 1:2600 E 12TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127
Practice Address - Country:US
Practice Address - Phone:816-965-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001709131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical