Healthcare Provider Details

I. General information

NPI: 1780967208
Provider Name (Legal Business Name): MARGARET JANE DUCKWORTH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET JANE CHOATE

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E TAMPA ST
SPRINGFIELD MO
65806
US

IV. Provider business mailing address

2465 E MEADOW DR
SPRINGFIELD MO
65804-4506
US

V. Phone/Fax

Practice location:
  • Phone: 417-831-0150
  • Fax: 417-865-3479
Mailing address:
  • Phone: 417-689-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2011029369
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2011029369
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: