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NPI Code Detail

MEDICARE: ALEXA J SUMMERS MSW, LCSW

MEDICARE: ALEXA J SUMMERS MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2017002037MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477959344
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA J SUMMERS MSW, LCSW
Provider Business Mailing Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Provider Business Practice Location Address
First Line : 210 N WILLIAMS ST UNIT C
Second Line :
City : MOBERLY
State : MO
Zip : 65270-1583
Country : US
Telephone Number : 660-263-7651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2014
Last Update Date : 10/09/2020

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