Provider Demographics
NPI:1881686103
Name:GROTH, JUNE KAY (MSW)
Entity type:Individual
Prefix:MS
First Name:JUNE
Middle Name:KAY
Last Name:GROTH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6342 LONG ST
Mailing Address - Street 2:STE A
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-2560
Mailing Address - Country:US
Mailing Address - Phone:913-962-9676
Mailing Address - Fax:913-962-9676
Practice Address - Street 1:6342 LONG ST
Practice Address - Street 2:STE A
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-2560
Practice Address - Country:US
Practice Address - Phone:913-962-9676
Practice Address - Fax:913-962-9676
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
028614OtherMANAGED HEALTH NETWORK
076918OtherVALUE OPTIONS
MO19604600OtherMAGELLAN BEHAVIORAL HEALT
231289OtherCOMPSYCH
2078053OtherCIGNA BEHAVIORAL HEALTH
MO23257022OtherBC/BS OF KANSAS CITY
6283738OtherUNITED BEHAVIORAL HEALTH
231289OtherCOMPSYCH