Active NPI
Debra Ann Waller-Lee, LCSW
- Clinical Social Worker
- Saint Louis, MO
National Provider Identifier
1013164599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 001992
- Practice address
- 915 N Grand Blvd
Saint Louis, MO 63106-1621 - Phone
- (314) 652-4100
- Fax
- (314) 845-5016
- NPI assigned
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 001992 | MO | Primary |
Addresses
Primary practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Mailing address
8390 Delmar Blvd Ste 210
Saint Louis, MO 63124-2117
Phone (314) 692-9010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001992 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monarch Immigrant Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1013164599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8390 DELMAR BLVD STE 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631242117",
"telephone_number": "314-692-9010",
"fax_number": "314-692-9014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 N GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631061621",
"telephone_number": "314-652-4100",
"fax_number": "314-845-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER-LEE",
"first_name": "DEBRA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "001992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.