Provider Demographics
NPI:1588068712
Name:SHOPE, CALVIN (LSCSW)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:SHOPE
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 HOUSTON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6497
Mailing Address - Country:US
Mailing Address - Phone:785-340-5297
Mailing Address - Fax:785-588-4652
Practice Address - Street 1:322 HOUSTON ST STE 102
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6497
Practice Address - Country:US
Practice Address - Phone:785-340-5297
Practice Address - Fax:785-588-4652
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS058971041C0700X
KS8959104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker