Pepper, Jacqueline
Pepper, Jacqueline is an sole proprietor health care provider with primary practice located at 1007 N College Ave St. 1, Columbia MO 65201-4794. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pepper, Jacqueline can be contacted via phone (573) 214-2253.Contact Information
Primary practice address
1007 N College Ave St. 1
Columbia MO 65201-4794
Phone: (573) 214-2253
Fax: (573) 474-5683
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW005246 | Missouri |
Profile Details
| NPI number | 1225021728 |
|---|---|
| LBN Legal business name | Pepper, Jacqueline |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Jul 12th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225021728 | NPPES |
| Missouri | MEDICAID | 498301332 | |
| Missouri | MEDICAID | 753424407 | |
| Missouri | Other | 24647036 |
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