Individual provider Active NPI

Jessica Kathleen Pangilinan, LCSW

  • Clinical Social Worker
  • Independence, MO
National Provider Identifier
1306401955
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2019015078 Issued in MO
Practice address
17886 E 23Rd St S
Independence, MO 64057-1840
Phone
(816) 836-6705
Fax
(816) 257-2575
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 2019015078 MO Primary

Addresses

Primary practice location

17886 E 23Rd St S
Independence, MO 64057-1840

Mailing address

PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214

Other names 1

  • Jessica Kathleen Foster 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
I20190702001559 MO Practitioner - Clinical Social Worker 2961736558 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019015078MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Aug 20, 2025 Accepting new patients
Burrell, Inc. CurrentSince Aug 20, 2025 Accepting new patients
A W Stevenson LLC CurrentSince Jun 10, 2024 Accepting new patients

Locations

17611 E US Highway 24
#H
Independence, MO 64056
Phone (816) 836-6350

17886 E 23rd St S
Independence, MO 64057
Phone (816) 836-6705

1310 Hrc Plaza Dr
Lake St Louis, MO 63367
Phone (636) 277-9890

400 N 5th St
Ste 201
Saint Charles, MO 63301
Phone (636) 238-2615

237 Creekside Office Dr
Wentzville, MO 63385
Phone (636) 202-1412

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1306401955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "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": "17886 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-836-6705",
            "fax_number": "816-257-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGILINAN",
        "first_name": "JESSICA",
        "middle_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019015078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FOSTER",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.