Individual provider Active NPI

Brian Shlosberg, LCSW

  • Clinical Social Worker
  • Olivette, MO
National Provider Identifier
1013653419
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2021008355 Issued in MO
Practice address
9378 Olive Blvd Ste 104a
Olivette, MO 63132-3222
Phone
(973) 960-6490
NPI assigned
May 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2021008355 MO Primary

Addresses

Primary practice location

9378 Olive Blvd Ste 104a
Olivette, MO 63132-3222

Mailing address

8052 Amherst Ave
Saint Louis, MO 63130-3603
Phone (973) 960-6490

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

LicenseStateTypeSpecialty
2021008355MOMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1013653419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8052 AMHERST AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631303603",
            "telephone_number": "973-960-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9378 OLIVE BLVD STE 104A",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631323222",
            "telephone_number": "973-960-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLOSBERG",
        "first_name": "BRIAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021008355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivette, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.