Provider Demographics
NPI:1396466967
Name:AGUIRRE, ISABELLA NADINE (LMSW)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:NADINE
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 SW KESSLER DR UNIT 7400
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2285
Mailing Address - Country:US
Mailing Address - Phone:816-344-0157
Mailing Address - Fax:
Practice Address - Street 1:3321 SW KESSLER DR UNIT 7400
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2285
Practice Address - Country:US
Practice Address - Phone:816-344-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021046759101Y00000X, 101YM0800X, 104100000X
KS12405101Y00000X, 104100000X, 1041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical