Breanna R Worstell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022033859 Issued in MO

Practice address

1949 Snowberry LN
Joplin, MO 64804-5420

Phone

(417) 347-7579

NPI assigned

Sep 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Breanna R Watt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1891416426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032526",
            "telephone_number": "417-347-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 SNOWBERRY LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648045420",
            "telephone_number": "417-347-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSTELL",
        "first_name": "BREANNA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022033859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "WATT",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacquelyn Marie Wooldridge, CNS
• Kayla Wooldridge, D.O.
• Minette Jane Woolven
• Workplace Medical Center, LLC
• Richard C. Worley, CRNA
• Wound Care at Home, LLC
• Alisha R Wright, D.O,
• Daniel Wright
• Kendra Wright, PHARMD
• Jian Wu

• Clinical Social Worker in Joplin, MO
• Providers in Joplin, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.