Provider Demographics
NPI:1447506555
Name:BRISTOW, LINDSEY (LCSW, RPT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BRISTOW
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12916 DELMAR ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2350
Mailing Address - Country:US
Mailing Address - Phone:913-709-6383
Mailing Address - Fax:
Practice Address - Street 1:10201 E 75TH ST
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-2333
Practice Address - Country:US
Practice Address - Phone:913-709-6383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MO20110362191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical