Provider Demographics
NPI:1962830828
Name:SCOTT, SHARI (MA)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:6420 LAKECREST DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9157
Mailing Address - Country:US
Mailing Address - Phone:816-204-6635
Mailing Address - Fax:
Practice Address - Street 1:609 NE 291 HWY
Practice Address - Street 2:STE. 110
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-2507
Practice Address - Country:US
Practice Address - Phone:816-204-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013038448101Y00000X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist