Matthew Fuqua, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022042255 Issued in MO

Practice address

1300 E Bradford Pkwy BLDG a
Springfield, MO 65804-4264

Phone

(417) 761-5000

NPI assigned

Apr 16, 2021

Last updated

Jun 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Burrell, Inc.

  dba Burrell Behavioral Health

  • Community/Behavioral Health Agency
  • Springfield, MO
  • NPI 1275541740
  Medicare reassignment NPD
• Burrell, Inc.

  dba Centerstone Pharmacy

  • Community/Retail Pharmacy
  • Springfield, MO
  • NPI 1194190066
  NPD

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1316528847",
    "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": "417-761-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY BLDG A",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "MATTHEW",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "11212-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022042255",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019027209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric J. Fulnecky, MD
• Christine Fultyn, PSYD
• Jessica Fulwider
• Eric Funk, M.D.
• Jenny Funk, DO
• Timothy Anthony Fursa, MD
• Beverly Lynn Furstenberg
• Jon M. Fusselman, MD
• Gabe Ariciu DC LLC
• Kennedi M Gabriel, MSW, LCSW

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, 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 Jun 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.