SearchMissouri1041C0700X

Michael Vanderwaal, LCSW

NPI 1669001665 · on the registry since 2020 · sole proprietor

Practice

Address
4110 Baltimore Ave
Kansas City, MO 64111
Phone
(816) 200-2320
Organisation at this address
Trellis Cares Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
104100000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-09-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri