Marisa Richardson
Individual provider Active NPI Clinical Social Worker · Desloge, MO
NPI 1891229019 · NPPES record last updated Apr 13, 2017
Key facts
- NPI
- 1891229019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 005719 (MO)
- Practice address
- 601 Meadowbrook CT
Desloge, MO 63601-3000 - Phone
- (573) 747-9789
- NPI assigned
- Apr 13, 2017
- 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)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005719 | MO | Yes |
Addresses
Primary practice location
601 Meadowbrook CT
Desloge, MO 63601-3000
Mailing address
601 Meadowbrook CT
Desloge, MO 63601-3000
Phone (573) 747-9789
Other providers in Desloge, MO
- Preferred Family Healthcare, Inc.
- Pyramid Hospice Services, Inc.
- Quality Health Care, Inc
- Quality Health Care, Inc.
- Reliable Home Care, Inc.
- Julia Rogers
- Holly Russell
- Kelsey Elizabeth Ryner
- Cara Shepard-Propst
- Molly C Smith
All providers in Desloge, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2017. 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.