Provider Demographics
NPI:1043475296
Name:SCHRAG, JENNIFER LEA (LSCSW, LCSW)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LEA
Last Name:SCHRAG
Suffix:
Gender:F
Credentials:LSCSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5408 W 58TH TER
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2856
Mailing Address - Country:US
Mailing Address - Phone:913-381-4992
Mailing Address - Fax:
Practice Address - Street 1:5408 W 58TH TER
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-2856
Practice Address - Country:US
Practice Address - Phone:913-381-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22881041C0700X
MO20020304921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical