Healthcare Provider Details

I. General information

NPI: 1124871793
Provider Name (Legal Business Name): JESSICA CLAIBOURN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N ORANGE ST
BUTLER MO
64730-9382
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax: 660-200-7403
Mailing address:
  • Phone: 660-885-8131
  • Fax: 660-885-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2026041195
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: