Individual provider Active NPI

Deanna M Dewitt, MSW, LCSW

  • Clinical Social Worker
  • Springfield, MO
National Provider Identifier
1174306005
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023021381 Issued in MO
Practice address
630 W Kearney St
Springfield, MO 65803-2508
Phone
(417) 761-5000
NPI assigned
Aug 15, 2023
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2023021381 MO Primary

Addresses

Primary practice location

630 W Kearney St
Springfield, MO 65803-2508

Mailing address

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5214

Other names 1

  • Deanna M Baca Former name

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
I20230821002151 MO Practitioner - Clinical Social Worker 0941662142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023021381MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Aug 17, 2023 Accepting new patients
Burrell, Inc. CurrentSince Aug 17, 2023 Accepting new patients

Locations

1300 E Bradford Pkwy
#H
Springfield, MO 65804

1423 N Jefferson Ave
Ste D200
Springfield, MO 65802
Phone (417) 761-5820

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5214

630 W Kearney St
Springfield, MO 65803
Phone (417) 761-5300

Organizations & group practices 2

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1174306005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "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": "630 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658032508",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "DEANNA",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023021381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "BACA",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.