Active NPI
Jolene Rene McQueen-Kidwell, LCSW
- Social Worker
- Fort Leonard Wood, MO
National Provider Identifier
1144720376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2016001530
- Practice address
- 4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098 - Phone
- (573) 596-0522
- NPI assigned
- Feb 14, 2018
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 2016001530 | MO | Primary |
Addresses
Primary practice location
4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Mailing address
4430 Missouri Ave # 1278
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-0522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1144720376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4430 MISSOURI AVE # 1278",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739098",
"telephone_number": "573-596-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4430 MISSOURI AVE",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739098",
"telephone_number": "573-596-0522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCQUEEN-KIDWELL",
"first_name": "JOLENE",
"middle_name": "RENE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2016001530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Leonard Wood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.