Provider Demographics
NPI:1871741058
Name:CENTIMANO, MEEKA MARIE (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:MEEKA
Middle Name:MARIE
Last Name:CENTIMANO
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 METCALF AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3931
Mailing Address - Country:US
Mailing Address - Phone:913-530-3837
Mailing Address - Fax:
Practice Address - Street 1:6405 METCALF AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3931
Practice Address - Country:US
Practice Address - Phone:913-530-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS38301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical