Individual provider Active NPI

Jessica L Dollar, LCSW

  • Clinical Social Worker
  • Saint Charles, MO
National Provider Identifier
1578208575
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022010288 Issued in MO
Practice address
330 1St Capitol Dr Ste 240
Saint Charles, MO 63301-2846
Phone
(314) 900-1112
Fax
(888) 920-1915
NPI assigned
May 3, 2022
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10498901 NY
Clinical Social Worker 1041C0700X 149027531 IL
Clinical Social Worker 1041C0700X 2022010288 MO Primary

Addresses

Primary practice location

330 1St Capitol Dr Ste 240
Saint Charles, MO 63301-2846

Mailing address

1078 Keystone Trail Dr
Wildwood, MO 63005-4265
Phone (314) 971-4664

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220524000975 MO Practitioner - Clinical Social Worker 3577940980 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10498901NYMDSocial Worker
149027531ILMDClinical Social Worker
2022010288MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Madmar, LLC Social Worker CurrentSince Mar 26, 2025 Accepting new patients
Fitzgibbons Psychological West County Psychological Associates PastSince May 18, 2021 Accepting new patients

Locations

1215 Fern Ridge Pkwy
#110W
Saint Louis, MO 63141
Phone (314) 275-8599

1215 Fern Ridge Pkwy
Ste 110
Saint Louis, MO 63141
Phone (314) 275-8599

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1578208575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 KEYSTONE TRAIL DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630054265",
            "telephone_number": "314-971-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 1ST CAPITOL DR STE 240",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012846",
            "telephone_number": "314-900-1112",
            "fax_number": "888-920-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLAR",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "10498901",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027531",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022010288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.