Healthcare Provider Details

I. General information

NPI: 1750200853
Provider Name (Legal Business Name): JAMIE L SKINNER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 BERRYWOOD DR STE 203
COLUMBIA MO
65201-6515
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-8455
  • Fax: 573-777-8465
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2026022112
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: