Healthcare Provider Details

I. General information

NPI: 1730064502
Provider Name (Legal Business Name): JENNIFER ELEANOR CONNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHAPEL DR STE E
MONETT MO
65708-9378
US

IV. Provider business mailing address

100 CHAPEL DR STE E
MONETT MO
65708-9378
US

V. Phone/Fax

Practice location:
  • Phone: 417-387-2042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025031757
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: