Active NPI
Jacqueline Nielson, LCSW
- Professional Counselor
- Sikeston, MO
National Provider Identifier
1497995005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 001652
- Practice address
- 760 Plantation Blvd
Sikeston, MO 63801-5736 - Phone
- (573) 471-0800
- Fax
- (573) 471-0810
- NPI assigned
- Feb 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 001652 | MO | Primary |
Addresses
Primary practice location
760 Plantation Blvd
Sikeston, MO 63801-5736
Mailing address
760 Plantation Blvd
PO Box 1403
Sikeston, MO 63801-5736
Phone (573) 471-0800
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235347200000",
"number": "1497995005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 PLANTATION BLVD",
"address_2": "PO BOX 1403",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638015736",
"telephone_number": "573-471-0800",
"fax_number": "573-471-0810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 PLANTATION BLVD",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638015736",
"telephone_number": "573-471-0800",
"fax_number": "573-471-0810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSON",
"first_name": "JACQUELINE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-23",
"last_updated": "2009-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "001652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sikeston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.