| Lori Kanke, Lcsw, Llc | |
|
2404 Highly St Saint Joseph MO 64506 | |
| (816) 351-9026 | |
| (816) 387-9307 |
| Full Name | Lori Kanke, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2404 Highly St, Saint Joseph, Missouri |
| Authorized Official Name and Position | Lori Ann Kanke (OWNER) |
| Authorized Official Contact | 8163519026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Kanke, Lcsw, Llc 2404 Highly St Saint Joseph MO 64506-2729 Ph: (816) 351-9026 | Lori Kanke, Lcsw, Llc 2404 Highly St Saint Joseph MO 64506 Ph: (816) 351-9026 |
| NPI Number | 1639611510 |
|---|---|
| Provider Enumeration Date | 11/09/2016 |
| Last Update Date | 06/07/2018 |
| Medicare PECOS PAC ID | 8729369020 |
|---|---|
| Medicare Enrollment ID | O20161228001378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639611510 | NPI | - | NPPES |
| 1235412537 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2015004773 (Missouri) | Primary |
| Provider Name | Lori Ann Kanke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235412537 PECOS PAC ID: 5698070936 Enrollment ID: I20160224000385 |
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