Provider Demographics
NPI:1992749261
Name:MAYSE, SHELLEY D (MSW, LCSW, LSCSW)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:D
Last Name:MAYSE
Suffix:
Gender:F
Credentials:MSW, LCSW, LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 ALLMAN RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66217-9452
Mailing Address - Country:US
Mailing Address - Phone:913-568-7515
Mailing Address - Fax:
Practice Address - Street 1:7515 ALLMAN RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66217
Practice Address - Country:US
Practice Address - Phone:913-568-7515
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010273961041C0700X
KS22251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical