Provider Demographics
NPI:1811874779
Name:MICHALSKI, SHANNON MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:MICHALSKI
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 1:1500 W 37TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3988
Mailing Address - Country:US
Mailing Address - Phone:660-383-2292
Mailing Address - Fax:
Practice Address - Street 1:1310 NW VIVION RD STE 102
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4553
Practice Address - Country:US
Practice Address - Phone:660-383-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025033834104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker