Provider Demographics
NPI:1942368808
Name:RIORDAN, KATHLEEN F (MSW MFT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:F
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MSW MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 MISSION RD
Mailing Address - Street 2:SUITE 248
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3032
Mailing Address - Country:US
Mailing Address - Phone:913-383-7882
Mailing Address - Fax:913-677-1422
Practice Address - Street 1:7301 MISSION RD
Practice Address - Street 2:SUITE 248
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3032
Practice Address - Country:US
Practice Address - Phone:913-383-7882
Practice Address - Fax:913-677-1422
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03081041C0700X
MO0047281041C0700X
KS208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002914Medicare ID - Type Unspecified