Jessica Back, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014012882 Issued in MO

Practice address

2804 Forum Blvd
3A
Columbia, MO 65203-6322

Phone

(573) 446-6290

NPI assigned

Aug 1, 2014

Sex

Female

Sole proprietor

Yes

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry D. Schneider, PH.D., LCSW, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbia, MO
  • NPI 1215230602
  NPD (past)
• Shelly M Ossana PHD LLC

  • Adult Mental Health Clinic/Center
  • Columbia, MO
  • NPI 1063190254
  NPD (past)

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1346658465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 FORUM BLVD",
            "address_2": "3A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036322",
            "telephone_number": "573-446-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 FORUM BLVD",
            "address_2": "3A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036322",
            "telephone_number": "573-446-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014012882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akram Mohamed Osman Babkir, MD
• Aleksandra Bacewicz, MD
• Alicia Caryn Bach, M.D.
• David Dollar Bach, RRT
• Bert E Bachrach, MD
• Kimberly Backes, RD
• Teresa Marie Backes, M.D.
• Suzette Mizutani Bacon, LCSW
• Valerie G Bader, RN,CNM
• Jillian Badgley

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, 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 Aug 1, 2014; 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.