Individual
AUDRA J MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1423 N JEFFERSON AVE FL 3, SPRINGFIELD, MO 65802-1917
(417) 761-5000
(417) 761-5000
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(417) 761-5000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2012018159
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245588466
—
MO
01
—
440552485
TRICARE
MO
Enumeration date
08/20/2012
Last updated
10/24/2023
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