Provider Demographics
NPI:1447705553
Name:SHARON RIDER LCSW LLC
Entity type:Organization
Organization Name:SHARON RIDER LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:816-372-5660
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-1092
Mailing Address - Country:US
Mailing Address - Phone:816-372-5660
Mailing Address - Fax:816-673-7561
Practice Address - Street 1:1201 NW BRIARCLIFF PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1878
Practice Address - Country:US
Practice Address - Phone:816-372-5660
Practice Address - Fax:816-673-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty