Individual provider Active NPI

Jennifer L Such, LCSW

  • Clinical Social Worker
  • Sikeston, MO
National Provider Identifier
1851802078
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
223 N Main St Ste 209
Sikeston, MO 63801-4211
Phone
(573) 475-6534
NPI assigned
Oct 15, 2017
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

223 N Main St Ste 209
Sikeston, MO 63801-4211

Mailing address

223 N Main St Ste 209
Sikeston, MO 63801-4211
Phone (573) 475-6534

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNO NUMBERS

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
I20221116002515 MO Practitioner - Clinical Social Worker 3476921834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

693 Sandywood Rd
Sikeston, MO 63801-8294
Phone (573) 475-6534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Such Counseling LLC Clinical CurrentSince Oct 28, 2022 Accepting new patients
Shine Medical Providers PC Single Specialty Past Accepting new patients
Shine Medical of Ca PC Single Specialty Past Accepting new patients

Locations

223 N Main St
Sikeston, MO 63801
Phone (573) 475-6534

Organizations & group practices 3

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": "1508025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1851802078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST STE 209",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014211",
            "telephone_number": "573-475-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST STE 209",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014211",
            "telephone_number": "573-475-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCH",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-15",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO NUMBERS",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.