Healthcare Provider Details

I. General information

NPI: 1902449085
Provider Name (Legal Business Name): MARIAH JADE HOBBS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAH JADE SANDER

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17611 E US HIGHWAY 24
INDEPENDENCE MO
64056-1853
US

IV. Provider business mailing address

1300 E BRADFORD PKWY
SPRINGFIELD MO
65804-4264
US

V. Phone/Fax

Practice location:
  • Phone: 816-836-6350
  • Fax:
Mailing address:
  • Phone: 417-761-5000
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2018044623
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: