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Contact Information

JERRY D WILMATH, LCSW LPC
2024 N 14
POPLAR BLUFF, MO63901
 Phone: 573-718-9315
 Fax: 573-686-2647
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Counselor

101Y00000X
Indicates primary specialty

NPI Profile & details for JERRY D WILMATH · (Male)

NPI # 1447267299
Status Active
Credentials LCSW LPC
Entity Individual
Enumeration date 08/02/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • MO License # 003564
  • MO License # LPC000167
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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