Brittany L Boren, LMSW
Individual provider Active NPI Social Worker · Rolla, MO
NPI 1629824750 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1629824750
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 2024035979 (MO)
- Practice address
- 1450 E 10TH St
Rolla, MO 65401-3648 - Phone
- (844) 853-8937
- NPI assigned
- Apr 29, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215130 | AK | MD | Social Worker |
| 13582 | KS | MD | Social Worker |
| 2024035979 | MO | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 215130 | AK | |
| Social Worker | 104100000X | 13582 | KS | |
| Social Worker | 104100000X | 2024035979 | MO | Yes |
Addresses
Primary practice location
1450 E 10TH St
Rolla, MO 65401-3648
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (844) 853-8937
Other practice location 1
2601 Anderson Ave Ste 104
Manhattan, KS 66502-2809
Phone (785) 510-0097
Other names
- Brittany L Thiele
Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.