JESIKA M CONVERSE (NPI# 1750940649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750940649 |
| Entity Type | Individual |
| Full Name | JESIKA M CONVERSE |
| Credential | MSM, LMSW |
| Practice Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 4177615000 |
| Practice Fax Number | 4177615065 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615065 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 2019014457 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490074371 | 05 | |
| CAQH | 14467421 | 01 |
| Street Address |
1300 E BRADFORD PKWY |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639175912 | Pascha J Boyd | Nurse Practitioner | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2005-06-22 |
| 1356942338 | Derek Lee Hennigh | Registered Nurse | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-11-05 |
| 1093316515 | Susan B Nutter | Pharmacist | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-11-02 |
| 1285234336 | Logan L Comegys | Social Worker | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-10-28 |
| 1568060192 | Christine M Reinheimer | Case Manager/Care Coordinator | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-10-15 |
| 1760089288 | Michele Litchy | Counselor | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-10-07 |
| 1770190092 | Rebecca D Mcgarry | Social Worker | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-09-30 |
| 1467066159 | Jamie Audsley | Case Manager/Care Coordinator | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-09-01 |
| 1720692429 | Shamon Williams | Case Manager/Care Coordinator | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-09-01 |
| 1831702448 | Stephanie M Brodwater | Case Manager/Care Coordinator | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513193 | Abigayle Anastasia Augustus | Social Worker | 161 Saffron Cir, Springfield, MA 01129-1514 | 2020-09-22 |
| 1063034742 | Ann Sarah Engel | Social Worker | 2101 E Watch Ave Apt 6, Springfield, IL 62702-6802 | 2020-05-15 |
| 1225670912 | Barbara A Otto | Social Worker | 3047 Willow Rd, Springfield, OH 45502-9073 | 2019-10-14 |
| 1326697509 | Nathalie Orelien | Social Worker | 267 Beacon Cir, Springfield, MA 01119-2047 | 2019-09-10 |
| 1306401617 | Laurie T Lauture-best | Social Worker | 25 Laurence St, Springfield, MA 01104-2607 | 2019-05-02 |
| 1881157121 | Amber Renee Hartman Ortez | Social Worker | 1514 S Fountain Ave, Springfield, OH 45506-2718 | 2019-04-12 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1447722061 | Arielle Coutinho | Social Worker | 343 Milltown Rd, Springfield, NJ 07081 | 2018-12-20 |
| 1740761931 | Laurie Sullivan | Social Worker | 112 Industry Ave, Springfield, MA 01104-3349 | 2018-08-24 |
| 1427546076 | Terrisue Jean Malone | Social Worker | 1918 Mechanicsburg Rd Apt Suite, Springfield, OH 45503-3147 | 2018-04-30 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.