Jessica Street, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2023044757 Issued in MO

Practice address

128 Enchanted Pkwy Ste 100
Manchester, MO 63021-5492

Phone

(636) 345-4056

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Counseling Nook

  • Clinical Social Worker
  • South Charleston, WV
  • NPI 1235873951
  NPD (past)
• The Sandbox LLC

  • Adolescent and Children Mental Health Clinic/Center
  • South Charleston, WV
  • NPI 1154278083
  NPD (past)

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1225792450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7098 BRIARWOOD DR",
            "city": "CEDAR HILL",
            "state": "MO",
            "postal_code": "630163421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ENCHANTED PKWY STE 100",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215492",
            "telephone_number": "636-345-4056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 D St",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253033103",
            "country_code": "US",
            "telephone_number": "304-887-2994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREET",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023044757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Louis Advanced Physical Therapy Services LLC
• Christine L. Stallis, MSW, LCSW
• Michael P Steele, O.D.
• Brian Stefani, PHARM.D.
• Strato3 LLC
• Ann M Sullivan, LPC
• T M McKenna Inc
• Rebecca Tate
• Richard Paul Taylor, D.D.S.
• Ryan Frederick Theen, DC, MSN, APRN, FNP-C

• Clinical Social Worker in Manchester, MO
• Providers in Manchester, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.