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NPI Code Detail

MEDICARE: JESSICA SUMMERS LMSW

MEDICARE: JESSICA SUMMERS LMSW
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
1104100000XSocial Worker2024040572MO

General Provider Information

NPI Number : 1710598966
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SUMMERS LMSW
Provider Business Mailing Address
First Line : 1800 COMMUNITY
Second Line :
City : CLINTON
State : MO
Zip : 64735-8804
Country : US
Telephone Number : 844-853-8937
Fax Number :
Provider Business Practice Location Address
First Line : 155 PARK DR
Second Line :
City : SAINT ROBERT
State : MO
Zip : 65584-7860
Country : US
Telephone Number : 844-853-8937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2020
Last Update Date : 10/30/2024

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Directions to “ JESSICA SUMMERS LMSW” Practice Location

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