Nicole Landwehr, MSW, LCSW, REAT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2017040184 Issued in MO

Practice address

7110 Oakland Ave
Suite 104
Saint Louis, MO 63117-1868

Phone

(314) 324-3835

NPI assigned

Dec 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carnelian LLC

  • Clinical Social Worker
  • O'Fallon, MO
  • NPI 1053069989
  NPD Authorized official

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1033654314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 MCKELVEY ROAD",
            "address_2": "STE L PMB 1322",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441870",
            "telephone_number": "314-324-3835",
            "fax_number": "314-552-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 OAKLAND AVE",
            "address_2": "SUITE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171868",
            "telephone_number": "314-324-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDWEHR",
        "first_name": "NICOLE",
        "credential": "MSW, LCSW, REAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2017040184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Philip Landolt, DO
• Laurie Ann Landra, PLPC
• Amber Landry
• Jacques P Landry, PHARM.D.
• Eric Carl Landsness, MD
• Alex Ryan Lane, MD
• Alyssa Renee Lane
• Donna K Lane, LCSW
• Gabriel Lane, MD
• Kari Lane

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.