Provider Demographics
NPI:1780878975
Name:CARR, KORTNEY ANGELA (LMSW)
Entity type:Individual
Prefix:MS
First Name:KORTNEY
Middle Name:ANGELA
Last Name:CARR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128-1254
Mailing Address - Country:US
Mailing Address - Phone:816-726-9735
Mailing Address - Fax:
Practice Address - Street 1:2907 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-1254
Practice Address - Country:US
Practice Address - Phone:816-726-9735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6996104100000X
MO2011009976104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker