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NPI Code Detail

MEDICARE: STACI R MCWOODS MSW, LCSW

MEDICARE: STACI R MCWOODS MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2019031610MO
21041C0700XClinical Social Worker2023004758MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
214530152OTHERCAQH

General Provider Information

NPI Number : 1245886241
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACI R MCWOODS MSW, LCSW
Provider Business Mailing Address
First Line : 1540 E EVERGREEN ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65803-4300
Country : US
Telephone Number : 417-823-2900
Fax Number : 417-823-2981
Provider Business Practice Location Address
First Line : 1540 E EVERGREEN ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65803-4300
Country : US
Telephone Number : 417-823-2900
Fax Number : 417-823-2981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2019
Last Update Date : 03/10/2026

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