Active NPI
Mary E Wenom, LCSW
- Clinical Social Worker
- Saint Peters, MO
National Provider Identifier
1073521639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW005179
- Practice address
- 1272 Jungermann Rd Ste C
Saint Peters, MO 63376-6968 - Phone
- (636) 928-5800
- NPI assigned
- Aug 3, 2006
- Last updated
- Feb 13, 2009
- 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 | SW005179 | MO | Primary |
Addresses
Primary practice location
1272 Jungermann Rd Ste C
Saint Peters, MO 63376-6968
Mailing address
13029 Twin Meadows CT
Saint Louis, MO 63146-1804
Phone (314) 434-5658
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW005179 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karen Maccausland, P.C. | Past | Accepting new patients | |
| Mercy Hospital South | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Families In Focus
- Mental Health Counselor
- Saint Peters, MO
- NPI 1245354067
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234483200000",
"number": "1073521639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13029 TWIN MEADOWS CT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631461804",
"telephone_number": "314-434-5658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1272 JUNGERMANN RD STE C",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633766968",
"telephone_number": "636-928-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENOM",
"first_name": "MARY",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2009-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "SW005179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.