Individual provider Active NPI

Kathryn Elizabeth Carroll, LCSW

  • Clinical Social Worker
  • West Plains, MO
National Provider Identifier
1154106524
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2025049636 Issued in MO
Practice address
1211 Porter Wagoner Blvd
West Plains, MO 65775-1826
Phone
(417) 257-6762
NPI assigned
Aug 25, 2023
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2025049636 MO Primary
Social Worker 104100000X 2023031347 MO

Addresses

Primary practice location

1211 Porter Wagoner Blvd
West Plains, MO 65775-1826

Mailing address

1211 Porter Wagoner Blvd
West Plains, MO 65775-1826
Phone (417) 257-6762

Other practice location 1

860 Lynn St
Lebanon, MO 65536-3810
Phone (844) 853-8937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003000637 MO Practitioner - Clinical Social Worker 1355795832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

860 Lynn St
Lebanon, MO 65536-3810
Phone (888) 403-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025049636MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center CurrentSince Aug 29, 2023 Accepting new patients
Compass Health, Inc Clinical CurrentSince Nov 18, 2025 Accepting new patients
Compass Health, Inc CurrentSince Nov 18, 2025 Accepting new patients
Ozarks Medical Center CurrentSince Aug 29, 2023 Accepting new patients
Ozarks Medical Center Current Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

860 Lynn St
Lebanon, MO 65536
Phone (417) 334-8337

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

1211 Porter Wagoner Blvd
West Plains, MO 65775
Phone (417) 257-6762

1211 Porter Wagoner Blvd
Ste 23
West Plains, MO 65775
Phone (417) 257-6762

Organizations & group practices 5

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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1154106524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 PORTER WAGONER BLVD",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751826",
            "telephone_number": "417-257-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PORTER WAGONER BLVD",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751826",
            "telephone_number": "417-257-6762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Lynn St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655363810",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2025049636",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2023031347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.