Healthcare Provider Details

I. General information

NPI: 1952226490
Provider Name (Legal Business Name): MELISSA NICKOLE CREWS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E 12TH ST STE 8
LAMAR MO
64759-2182
US

IV. Provider business mailing address

1301 E 12TH ST STE 8
LAMAR MO
64759-2182
US

V. Phone/Fax

Practice location:
  • Phone: 417-214-3309
  • Fax: 417-682-5548
Mailing address:
  • Phone: 417-214-3309
  • Fax: 417-682-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2026038352
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: