MEDICARE: MRS. NANCY GAYLE JAMERSON 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
1	1041C0700X	Clinical Social Worker	000619	MO
2	225XM0800X	Mental Health Occupational Therapist	000619	MO
3	101YM0800X	Mental Health Counselor	000619	MO

General Provider Information

NPI Number	:	1316921018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY GAYLE JAMERSON LCSW

Provider Business Mailing Address
First Line	:	1203 E 18TH ST
Second Line	:
City	:	LAMAR
State	:	MO
Zip	:	64759-2416
Country	:	US
Telephone Number	:	417-214-3966
Fax Number	:

Provider Business Practice Location Address
First Line	:	BARTON COUNTY HEALTH DEPARTMENT
Second Line	:	1301 EAST 12TH ST.
City	:	LAMAR
State	:	MO
Zip	:	64759-6475
Country	:	US
Telephone Number	:	417-214-3966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	03/16/2023

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