Provider Demographics
NPI:1043861933
Name:VIOLETT, CAITLYN SHIRK (LMSW)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:SHIRK
Last Name:VIOLETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:ANN
Other - Last Name:SHIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 NE 83RD ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-4460
Mailing Address - Country:US
Mailing Address - Phone:816-877-0488
Mailing Address - Fax:
Practice Address - Street 1:3100 NE 83RD ST STE 1001
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-4460
Practice Address - Country:US
Practice Address - Phone:816-877-0488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018027753104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker