Healthcare Provider Details

I. General information

NPI: 1164109013
Provider Name (Legal Business Name): JESSICA MARKOWSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA SCHRADER

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7905 BIG BEND BLVD STE 2
WEBSTER GROVES MO
63119
US

IV. Provider business mailing address

5641 FINKMAN ST # 2F
SAINT LOUIS MO
63109
US

V. Phone/Fax

Practice location:
  • Phone: 317-200-5428
  • Fax:
Mailing address:
  • Phone: 317-220-1812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024012737
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: