Provider Demographics
NPI:1720487713
Name:LASLEY, GARY JR (LMSW)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:LASLEY
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32557 W 173RD ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-9222
Mailing Address - Country:US
Mailing Address - Phone:816-217-8367
Mailing Address - Fax:
Practice Address - Street 1:32557 W 173RD ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-9222
Practice Address - Country:US
Practice Address - Phone:816-217-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker