Individual provider Active NPI

Jeanine Louise Thomas, LCSW

  • Clinical Social Worker
  • Troy, MO
National Provider Identifier
1225409162
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2014024206 Issued in MO
Practice address
91 Troy SQ Ste 101
Troy, MO 63379-3228
Phone
(888) 403-1071
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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 2014024206 MO Primary

Addresses

Primary practice location

91 Troy SQ Ste 101
Troy, MO 63379-3228

Mailing address

1800 Community
Clinton, MO 64735-8804

Other practice location 1

19515 Brune Pkwy
Warrenton, MO 63383-6505
Phone (636) 456-1500

Other names 1

  • Jeanine Louise Gallagher Former name

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014024206MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1225409162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 TROY SQ STE 101",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633793228",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19515 Brune Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633836505",
            "country_code": "US",
            "telephone_number": "636-456-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JEANINE",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014024206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANINE",
            "last_name": "GALLAGHER",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.