Eagles Wings Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EAGLES WINGS COUNSELING LLC

Practice address

3322 S Campbell Ave
Springfield, MO 65807-4980

Phone

(417) 207-9039

Fax

(855) 425-0096

NPI assigned

Dec 12, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jesika GomezNPI 1750940649

Title

Owner

Phone

(417) 207-9039

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesika M Gomez, MSM, LCSW

  • Clinical Social Worker
  • Springfield, MO
  • NPI 1750940649
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1063280899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S NATALIE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658029702",
            "telephone_number": "417-207-9039",
            "fax_number": "855-425-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074980",
            "telephone_number": "417-207-9039",
            "fax_number": "855-425-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES WINGS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "JESIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-207-9039"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Dyck
• Michael S Dye Sr., LMSW
• Dynamic Dna Laboratories, LLC
• Denniese Dysart, M.S., L.P.C.
• Eagle Crest Counseling Center, Inc.
• Fredrick Lee Eagles
• Brendan Michael Earley, PHARMD
• Brandy M Earls, CD(DONA)
• Daniel J. Earnest, PA-C
• Easter Seals Midwest

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.