Active NPI
Molly Bergamini
- Clinical Social Worker
- Creve Coeur, MO
National Provider Identifier
1053787135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2014028727
- Practice address
- 711 Old Ballas Rd
Suite 203
Creve Coeur, MO 63141-7051 - Phone
- (314) 569-2253
- NPI assigned
- Aug 12, 2015
- Last updated
- Mar 2, 2017
- 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 | 2014028727 | MO | Primary |
Addresses
Primary practice location
711 Old Ballas Rd
Suite 203
Creve Coeur, MO 63141-7051
Mailing address
711 Old Ballas Rd
Suite 203
Creve Coeur, MO 63141-7051
Phone (314) 569-2253
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 |
|---|---|---|---|
| 2014028727 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488412800000",
"number": "1053787135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 OLD BALLAS RD",
"address_2": "SUITE 203",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417051",
"telephone_number": "314-569-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 OLD BALLAS RD",
"address_2": "SUITE 203",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417051",
"telephone_number": "314-569-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGAMINI",
"first_name": "MOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-12",
"last_updated": "2017-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2014028727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.