Provider Demographics
NPI:1801654405
Name:LOCKETT, STEFANI (LMSW)
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:LOCKETT
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 1:1923 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2331
Mailing Address - Country:US
Mailing Address - Phone:913-215-2547
Mailing Address - Fax:
Practice Address - Street 1:1923 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2331
Practice Address - Country:US
Practice Address - Phone:913-215-2547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13010104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker