Healthcare Provider Details

I. General information

NPI: 1396069910
Provider Name (Legal Business Name): JARED VERNELL INGLE PLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 S NATIONAL AVE
SPRINGFIELD MO
65804-4247
US

IV. Provider business mailing address

3022 S NATIONAL AVE
SPRINGFIELD MO
65804-4247
US

V. Phone/Fax

Practice location:
  • Phone: 417-597-4572
  • Fax: 417-882-1507
Mailing address:
  • Phone: 417-597-4572
  • Fax: 417-882-1507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026033708
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: