Active NPI
Wendy R Jackson, LCSW
- Clinical Social Worker
- Springfield, MO
National Provider Identifier
1063299675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2008030957
- Practice address
- 2885 W Battlefield St
Springfield, MO 65807-3952 - Phone
- (417) 761-5800
- Fax
- (417) 761-5580
- NPI assigned
- Sep 8, 2023
- Last updated
- Sep 3, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2008030957 | MO | Primary |
Addresses
Primary practice location
2885 W Battlefield St
Springfield, MO 65807-3952
Mailing address
PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008030957 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burrell, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1063299675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844715",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641844715",
"telephone_number": "417-761-5214",
"fax_number": "417-761-5065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2885 W BATTLEFIELD ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658073952",
"telephone_number": "417-761-5800",
"fax_number": "417-761-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "WENDY",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-08",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2008030957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.