Latisha Jo Richeson, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Unionville, MO

NPI 1780213397 · NPPES record last updated Apr 6, 2020

Key facts

NPI
1780213397
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2013017695 (MO)
Practice address
1926 Oak St
Unionville, MO 63565-1180
Phone
(660) 947-3673
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2013017695MOMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2013017695 MO Yes

Addresses

Primary practice location

1926 Oak St
Unionville, MO 63565-1180

Mailing address

213 Markham CT
Brookfield, MO 64628-1953
Phone (816) 304-6183

Other providers in Unionville, MO

All providers in Unionville, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.