Individual provider Active NPI

Richard Leroy Zelle III, LMSW

  • Social Worker
  • Union, MO
National Provider Identifier
1417750050
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2025043142 Issued in MO
Practice address
500 Clark Ave
Union, MO 63084-1004
Phone
(844) 853-8937
Fax
(660) 885-3690
NPI assigned
Mar 29, 2025
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2025043142 MO Primary

Addresses

Primary practice location

500 Clark Ave
Union, MO 63084-1004

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (844) 853-8937

Other practice location 1

1196 W South Jordan Pkwy Ste D2
South Jordan, UT 84095-4604
Phone (385) 533-9590

Other identifiers 1

IdentifierTypeStateIssuer
490165803MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2025043142MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nativation Counseling CurrentSince May 11, 2025 Accepting new patients
Valere Behavioral Health LLC CurrentSince Jun 3, 2025 Accepting new patients

Locations

1196 W South Jordan Pkwy
Ste D2
South Jordan, UT 84095
Phone (385) 503-8398

Organizations & group practices 2

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": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1417750050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "844-853-8937",
            "fax_number": "660-885-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CLARK AVE",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841004",
            "telephone_number": "844-853-8937",
            "fax_number": "660-885-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1196 W South Jordan Pkwy Ste D2",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840954604",
            "country_code": "US",
            "telephone_number": "385-533-9590",
            "fax_number": "385-446-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZELLE",
        "first_name": "RICHARD",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2025043142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490165803",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.