Organization Active NPI

Sarah Tyndall LLC

  • Clinical Social Worker
  • Kirkwood, MO
National Provider Identifier
1073222683
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SARAH TYNDALL LLC
Practice address
140 Prospect Ave Ste H
Kirkwood, MO 63122-6024
Phone
(314) 516-3753
Fax
(833) 902-1016
NPI assigned
Nov 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Sarah Tyndall, LCSWNPI 1508195538
Title
Owner
Phone
(314) 516-3753

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

140 Prospect Ave Ste H
Kirkwood, MO 63122-6024

Mailing address

3845 Flad Ave
Saint Louis, MO 63110-4023
Phone (314) 516-3753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230125001816 MO Part B Supplier - Clinic/Group Practice 5890166029 Receives reassigned benefits from 1 practitioner
Practice locations: Kirkwood, MO

National Provider Directory

National Provider Directory

Locations

140 Prospect Ave
Ste H
Kirkwood, MO 63122
Phone (314) 308-9115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1073222683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 FLAD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104023",
            "telephone_number": "314-516-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE STE H",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226024",
            "telephone_number": "314-516-3753",
            "fax_number": "833-902-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARAH TYNDALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "TYNDALL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-516-3753",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.