Healthcare Provider Details

I. General information

NPI: 1215857412
Provider Name (Legal Business Name): LEAH RACHEL JONES LMSW CRADC CPS MARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 S KINGSHIGHWAY STE F
CAPE GIRARDEAU MO
63703-7676
US

IV. Provider business mailing address

760 S KINGSHIGHWAY STE F
CAPE GIRARDEAU MO
63703-7676
US

V. Phone/Fax

Practice location:
  • Phone: 573-335-4333
  • Fax: 573-335-4345
Mailing address:
  • Phone: 573-335-4333
  • Fax: 573-335-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: