Healthcare Provider Details

I. General information

NPI: 1801714795
Provider Name (Legal Business Name): RUBY VELA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N CENTRAL AVE
MONETT MO
65708-1144
US

IV. Provider business mailing address

PO BOX 100
PIERCE CITY MO
65723-2100
US

V. Phone/Fax

Practice location:
  • Phone: 417-476-1000
  • Fax:
Mailing address:
  • Phone: 417-476-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2026023913
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: