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Individual

MRS. JACINDA REA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
203 2ND AVE SW, MIAMI, OK 74354-6818
(417) 214-6648
Mailing address
406 E 3RD TER, LAMAR, MO 64759-1150
(417) 214-6648

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2016029485
MO
1041C0700X
Clinical Social Worker
Primary
5174
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002628535
CTS CHILDRENS TREATMENT SERVICES
MO
01
1280287
MO CARE
MO
05
1730457300
MO
01
4277661
AETNA
MO
01
601117207
MAGELLAN
MO
01
D27240
HEALTHLINK
MO
Enumeration date
12/09/2011
Last updated
07/07/2025
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