Provider Demographics
NPI:1285304253
Name:DEANNA SACK, LLC
Entity type:Organization
Organization Name:DEANNA SACK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-980-2230
Mailing Address - Street 1:501 W 89TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3510
Mailing Address - Country:US
Mailing Address - Phone:913-980-2230
Mailing Address - Fax:816-227-6931
Practice Address - Street 1:9200 INDIAN CREEK PKWY STE 660
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2097
Practice Address - Country:US
Practice Address - Phone:913-980-2230
Practice Address - Fax:816-227-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty