Healthcare Provider Details

I. General information

NPI: 1750006037
Provider Name (Legal Business Name): ALEXANDER J PARDINI LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1949 SNOWBERRY LN
JOPLIN MO
64804-5420
US

IV. Provider business mailing address

1949 SNOWBERRY LN
JOPLIN MO
64804-5420
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-7860
  • Fax:
Mailing address:
  • Phone: 417-347-7860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025050510
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: