Jacinda Rea, LCSW
Individual provider Active NPI Clinical Social Worker · Miami, OK
NPI 1730457300 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1730457300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 5174 (OK)
- Practice address
- 203 2ND Ave SW
Miami, OK 74354-6818 - Phone
- (417) 214-6648
- NPI assigned
- Dec 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161018002169 | MO | Practitioner - Clinical Social Worker | 0446548820 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current |
Accepting new patients |
| Advantage Counseling Associates | Current | Accepting new patients | |
| Psylin, Inc. | Past | Accepting new patients |
Locations
4625 Lindell Blvd
Ste 200
Saint Louis, MO 63108
Phone (314) 833-8765
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2016029485 | MO | |
| Clinical Social Worker | 1041C0700X | 5174 | OK | Yes |
Addresses
Primary practice location
203 2ND Ave SW
Miami, OK 74354-6818
Mailing address
406 E 3Rd Ter
Lamar, MO 64759-1150
Phone (417) 214-6648
Other practice location 1
203 W 11th St
LaMar, MO 64759-1426
Phone (417) 214-6648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D27240 | Other | MO | HEALTHLINK |
| 1280287 | Other | MO | MO CARE |
| 002628535 | Other | MO | CTS CHILDRENS TREATMENT SERVICES |
| 1730457300 | Medicaid | MO | |
| 4277661 | Other | MO | AETNA |
| 601117207 | Other | MO | MAGELLAN |
Other providers in Miami, OK
- Rachel Kathryn Ramsey
- Anthony E Randle
- Melinda Monk Randle
- Nicholas Shane Randolph
- Bryan Rea
- Renal Treatment Centers West Inc
- Raquel Nichole Reno
- Rachael Dawn Rhodes
- Jean Gabriel Richard
- Victoria Ann Rigdon
All providers in Miami, OK · Clinical Social Worker in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.