Benton Drew Tolleson, LMSW

Individual provider Active NPI Clinical Social Worker · Kimberling City, MO

NPI 1477199503 · NPPES record last updated Jun 2, 2026

Key facts

NPI
1477199503
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2022019269 (MO)
Practice address
11863 State Highway 13
Kimberling City, MO 65686-8362
Phone
(417) 739-1995
Fax
(417) 739-1983
NPI assigned
Nov 25, 2019
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230923000519 MO Practitioner - Clinical Social Worker 1052765195 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Fordland Clinic, Inc. Current
since Aug 12, 2023
Accepting new patients
Fordland Clinic, Inc. Current Accepting new patients
Fordland Clinic, Inc. Current
since Aug 12, 2023
Accepting new patients

Locations

1059 Barton Dr
Fordland, MO 65652
Phone (417) 767-2100

11863 State Highway 13
Ste 1
Kimberling City, MO 65686
Phone (417) 739-2520

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2022019269 MO Yes

Addresses

Primary practice location

11863 State Highway 13
Kimberling City, MO 65686-8362

Mailing address

1059 Barton Dr
Fordland, MO 65652-7350
Phone (417) 767-2273

Other practice location 1

1059 Barton Dr
Fordland, MO 65652-7350
Phone (417) 767-2273 ext. 2012

Other providers in Kimberling City, MO

All providers in Kimberling City, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.