Provider Demographics
NPI:1013984707
Name:SCHOENECK, LEE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:SCHOENECK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 FARAON ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3512
Mailing Address - Country:US
Mailing Address - Phone:816-271-1066
Mailing Address - Fax:816-271-6786
Practice Address - Street 1:802 N RIVERSIDE RD STE 100B
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2502
Practice Address - Country:US
Practice Address - Phone:816-271-8133
Practice Address - Fax:816-271-8134
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4935104100000X
MO2002018126104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO495027203Medicaid
KS100117700AMedicaid