Individual provider Active NPI

Wendy Sue Myers, MSW, LCSW

  • Clinical Social Worker
  • Joplin, MO
National Provider Identifier
1306179395
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2011022907 Issued in MO
Practice address
1329 E 32ND St Ste 11
Joplin, MO 64804-2969
Phone
(417) 439-3334
NPI assigned
Sep 9, 2009
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7975 OK
Clinical Social Worker 1041C0700X 2011022907 MO Primary

Addresses

Primary practice location

1329 E 32ND St Ste 11
Joplin, MO 64804-2969

Mailing address

1329 E 32ND St Ste 11
Joplin, MO 64804-2969
Phone (417) 439-3334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20210825002024 OK Practitioner - Clinical Social Worker 5092982801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011022907MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Aug 16, 2021 Accepting new patients
Grand Lake Mental Health Center Inc CurrentSince Aug 16, 2021 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

Organizations & group practices 3

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1306179395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 E 32ND ST STE 11",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042969",
            "telephone_number": "417-439-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 E 32ND ST STE 11",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042969",
            "telephone_number": "417-439-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "WENDY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "7975",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011022907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.