Provider Demographics
NPI:1396781951
Name:THOMAS, JEFFRY SCOTT (LCSW)
Entity type:Individual
Prefix:
First Name:JEFFRY
Middle Name:SCOTT
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 NE BROOKTREE LN
Mailing Address - Street 2:STE 230
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-1890
Mailing Address - Country:US
Mailing Address - Phone:816-708-1620
Mailing Address - Fax:816-873-8471
Practice Address - Street 1:3000 NE BROOKTREE LN
Practice Address - Street 2:STE 230
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-1890
Practice Address - Country:US
Practice Address - Phone:816-708-1620
Practice Address - Fax:816-873-8471
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1827-M104100000X
MO20090149531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker