Provider Demographics
NPI:1447339320
Name:SHRINK INC
Entity type:Organization
Organization Name:SHRINK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF SHRINK INC THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:913-791-3805
Mailing Address - Street 1:6001 W 62ND STREET
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:913-791-3805
Mailing Address - Fax:913-677-1114
Practice Address - Street 1:3520 W 75TH STREET
Practice Address - Street 2:STE 200
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208
Practice Address - Country:US
Practice Address - Phone:913-791-3805
Practice Address - Fax:913-677-1114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHRINK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-03
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS506186OtherBCB SHIELD OF KANSAS
20411011OtherCOMPANY BLUE CROSS BLUE S
14633011OtherPROVIDER BLUE CROSS BLUE
R872273Medicare ID - Type UnspecifiedPROVIDER
14633011OtherPROVIDER BLUE CROSS BLUE