Provider Demographics
NPI:1134855216
Name:REID, ANNA E (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:E
Last Name:REID
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1303
Mailing Address - Country:US
Mailing Address - Phone:816-533-5855
Mailing Address - Fax:
Practice Address - Street 1:200 NE MISSOURI RD STE 307
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4722
Practice Address - Country:US
Practice Address - Phone:816-839-9427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021037372104100000X
MO20230414071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1447903380Medicaid
MO20230414507OtherCLINICAL LICENSURE NUMBER FROM MO SOCIAL WORK COMMITTEE