Provider Demographics
NPI:1063762334
Name:JOBST, REBECCA KRISTINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:KRISTINA
Last Name:JOBST
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 1:5640 N POTTER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-4128
Mailing Address - Country:US
Mailing Address - Phone:816-830-0618
Mailing Address - Fax:816-453-9814
Practice Address - Street 1:5640 N POTTER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-4128
Practice Address - Country:US
Practice Address - Phone:816-830-0618
Practice Address - Fax:816-453-9814
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050295931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical