Provider Demographics
NPI:1922422948
Name:RAUCH, JAMES E (LSCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:RAUCH
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11417 W 99TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-2416
Mailing Address - Country:US
Mailing Address - Phone:913-961-0794
Mailing Address - Fax:
Practice Address - Street 1:100 LAKEMARY DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1855
Practice Address - Country:US
Practice Address - Phone:913-557-4000
Practice Address - Fax:913-557-4910
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW24391041C0700X
MOLCSW0016061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical