Provider Demographics
NPI:1932757598
Name:HEENAN-MAGINNESS, JILLIAN BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:BETH
Last Name:HEENAN-MAGINNESS
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 1:300 W 19TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2026
Mailing Address - Country:US
Mailing Address - Phone:816-404-1000
Mailing Address - Fax:
Practice Address - Street 1:1800 E TRUMAN RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-1938
Practice Address - Country:US
Practice Address - Phone:816-404-6307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018042832104100000X
ID424371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker