| Irene Bockelman, Lscsw, Llc | |
|
10965 Granada Ln Suite 103 Overland Park KS 66211-1469 | |
| (913) 634-4196 | |
| (913) 780-6955 |
| Full Name | Irene Bockelman, Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10965 Granada Ln, Overland Park, Kansas |
| Authorized Official Name and Position | Irene Bockelman (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9136344196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irene Bockelman, Lscsw, Llc 16102 W 124th Ter Olathe KS 66062-4310 Ph: (913) 634-4196 | Irene Bockelman, Lscsw, Llc 10965 Granada Ln Suite 103 Overland Park KS 66211-1469 Ph: (913) 634-4196 |
| NPI Number | 1508139866 |
|---|---|
| Provider Enumeration Date | 02/17/2012 |
| Last Update Date | 02/17/2012 |
| Medicare PECOS PAC ID | 7214199090 |
|---|---|
| Medicare Enrollment ID | O20120425000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508139866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LSCSW 863 (Kansas) | Primary |
| Provider Name | Irene Bockelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811988306 PECOS PAC ID: 3779689989 Enrollment ID: I20120425000200 |
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