Provider Demographics
NPI:1427112952
Name:KING, SALLY (MSW, LCSW, LSCSW)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:MSW, LCSW, LSCSW
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:KNEIBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, LSCSW
Mailing Address - Street 1:PO BOX 45052
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64171-8052
Mailing Address - Country:US
Mailing Address - Phone:816-226-8211
Mailing Address - Fax:
Practice Address - Street 1:7423 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1523
Practice Address - Country:US
Practice Address - Phone:816-226-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060096611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical