Putthoff, Connie Mae
Putthoff, Connie Mae is an individual health care provider with primary practice located at 901 Ne Independence Ave , Lees Summit MO 64086-5544. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Putthoff, Connie Mae can be contacted via phone (816) 347-3017.Contact Information
Primary practice address
901 Ne Independence Ave
Lees Summit MO 64086-5544
Phone: (816) 347-3017
Fax: (816) 246-8207
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2479 | Kansas |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2004025819 | Missouri |
Profile Details
| NPI number | 1053464297 |
|---|---|
| LBN Legal business name | Putthoff, Connie Mae |
| Credentials | LSCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Apr 26th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053464297 | NPPES |
| Kansas | MEDICAID | 100098080A | |
| Kansas | Other | 100098080C |
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