Provider Demographics
NPI:1316615453
Name:KELSEY, SACIA DIANE (LMSW)
Entity type:Individual
Prefix:
First Name:SACIA
Middle Name:DIANE
Last Name:KELSEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SACIA
Other - Middle Name:DIANE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:933 MCGEE ST UNIT 514
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-2218
Mailing Address - Country:US
Mailing Address - Phone:785-258-4332
Mailing Address - Fax:
Practice Address - Street 1:3751 W MAIN ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-8446
Practice Address - Country:US
Practice Address - Phone:620-331-1748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12052104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker