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7611 State Line Rd Suite 226 Kansas City MO 64114-6801 | |
| (816) 753-7071 | |
| (816) 926-9180 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 7611 State Line Rd, Kansas City, Missouri |
| Authorized Official Name and Position | Lori B Schwartz (OWNER & PSYCHOLOGIST) |
| Authorized Official Contact | 8167537071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7611 State Line Rd Suite 226 Kansas City MO 64114-6801 Ph: (816) 753-7071 | 7611 State Line Rd Suite 226 Kansas City MO 64114-6801 Ph: (816) 753-7071 |
| NPI Number | 1962652321 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 10/24/2022 |
| Certification Date | 10/24/2022 |
| Medicare PECOS PAC ID | 8729148036 |
|---|---|
| Medicare Enrollment ID | O20081117000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962652321 | NPI | - | NPPES |
| 19138028 | Other | MO | BLUE CROSS BLUE SHIELD OF KC |
| 493607105 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | PY01564 (Missouri) | Secondary |
| Provider Name | Lori B Schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972521292 PECOS PAC ID: 2567522873 Enrollment ID: I20081117000441 |
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