Healthcare Provider Details

I. General information

NPI: 1063252732
Provider Name (Legal Business Name): JAMIE JARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE JARRETT

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 W MAIN ST STE 101
BLUE SPRINGS MO
64015-3648
US

IV. Provider business mailing address

2720 S SANTA FE RD
INDEPENDENCE MO
64052-3229
US

V. Phone/Fax

Practice location:
  • Phone: 913-730-5808
  • Fax:
Mailing address:
  • Phone: 816-805-2436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2023027153
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: