Healthcare Provider Details

I. General information

NPI: 1881404077
Provider Name (Legal Business Name): JONNA WILSON CAUSEY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 DIVISION DR
WEST PLAINS MO
65775-5789
US

IV. Provider business mailing address

1925 DOMINION WAY
COLORADO SPRINGS CO
80918-1483
US

V. Phone/Fax

Practice location:
  • Phone: 417-257-9152
  • Fax:
Mailing address:
  • Phone: 719-300-5735
  • Fax: 719-931-5603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2025052163
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009927121
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: