Provider Demographics
NPI:1699878512
Name:MAYER, SANDRA BETH (LSCSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:BETH
Last Name:MAYER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E. 104TH ST.
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7104
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:12541 FOSTER ST STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2304
Practice Address - Country:US
Practice Address - Phone:913-317-3200
Practice Address - Fax:913-317-3218
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
25811013OtherBCBS OF KC
KS100098010Medicaid
S21823Medicare UPIN
KS100098010Medicaid