Provider Demographics
NPI:1578208575
Name:DOLLAR, JESSICA L (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:DOLLAR
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 KEYSTONE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-4265
Mailing Address - Country:US
Mailing Address - Phone:314-971-4664
Mailing Address - Fax:
Practice Address - Street 1:330 1ST CAPITOL DR STE 240
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2846
Practice Address - Country:US
Practice Address - Phone:314-900-1112
Practice Address - Fax:888-920-1915
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10498901104100000X
IL1490275311041C0700X
MO20220102881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker