Individual provider Active NPI

Ernest Edward Garrett III, LCSW, LICSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1114481397
Registry record updated May 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2011008912 Issued in MO
Practice address
4625 Lindell Blvd FL 2
Saint Louis, MO 63108-3739
Phone
(314) 866-8116
Fax
(314) 639-9996
NPI assigned
Jan 22, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 16252 LA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 4838C AL
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 8370-123 WI
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LC50080815 DC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 2011008912 MO Primary

Addresses

Primary practice location

4625 Lindell Blvd FL 2
Saint Louis, MO 63108-3739

Mailing address

4625 Lindell Blvd FL 2
Saint Louis, MO 63108-3739
Phone (314) 866-8116

Other identifiers 1

IdentifierTypeStateIssuer
496591702MedicaidMO

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
4838CALMDClinical Social Worker
LC50080815DCMDClinical Social Worker
16252LAMDClinical Social Worker
2011008912MOMDClinical Social Worker
8370-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Garrett LCSW & Consulting, L.L.C. Clinical CurrentSince Jul 25, 2021 Accepting new patients

Locations

4625 Lindell Blvd
Fl 2
Saint Louis, MO 63108
Phone (314) 866-8116

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1114481397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083739",
            "telephone_number": "314-866-8116",
            "fax_number": "314-639-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083739",
            "telephone_number": "314-866-8116",
            "fax_number": "314-639-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "ERNEST",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "16252",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4838C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8370-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080815",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011008912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496591702",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; 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.