MRS. KELLY RAE STADDIE LCSW
NPI 1093879835
Social Worker - Clinical in Mexico, MO

Active since December 19, 2006
734 W MONROE ST, MEXICO, MO 65265(573) 642-5345(573) 642-5162 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Kelly Rae Staddie Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KELLY RAE STADDIE LCSW (NPI 1093879835) is an individual clinical provider in Mexico, Missouri, licensed in Missouri (2005008356) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1093879835
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. KELLY RAE STADDIECredential: LCSW
Location Address734 W MONROE STMexico, MO 65265-1970
Mailing Address24 Lakeside PlMexico, MO 65265-2227 · (573) 582-7866
Fax(573) 642-5162
Sole ProprietorNo
Enumeration DateDecember 19, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1093879835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MO · 2005008356
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

734 W MONROE ST, Mexico, MO 65265

Other Names 1

Professional Name (2)Miss Kelly Rae Sportsman

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
734 W MONROE ST
MEXICO, MO 65265
Social Worker (Clinical)
734 W MONROE ST
MEXICO, MO 65265
Nurse Practitioner (Family)
734 W MONROE ST
MEXICO, MO 65265
Counselor (Professional)
734 W MONROE ST
MEXICO, MO 65265
Social Worker (Clinical)
734 W MONROE ST
MEXICO, MO 65265
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
734 W MONROE ST
MEXICO, MO 65265
Counselor (Mental Health)
734 W MONROE ST
MEXICO, MO 65265

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Staddie's NPI number?

The NPI number for Kelly Staddie is 1093879835. It was assigned to this individual provider in the NPPES registry on December 19, 2006. The provider is also known as Miss Kelly Rae Sportsman.

Where is Kelly Staddie located?

Kelly Staddie practices at 734 W Monroe St, Mexico, MO 65265. The listed phone number is (573) 642-5345.

What is Kelly Staddie's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kelly Staddie was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.