Active NPI
Nicole Marie Patterson, LCSW
- Clinical Social Worker
- Saint Charles, MO
National Provider Identifier
1134484694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 077579
- Practice address
- 2536 S Old Highway 94 Ste 214
Saint Charles, MO 63303-5612 - Phone
- (636) 875-9901
- NPI assigned
- Jul 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 077579 | NY | Primary |
Addresses
Primary practice location
2536 S Old Highway 94 Ste 214
Saint Charles, MO 63303-5612
Mailing address
3461 Beldeer Dr
Saint Charles, MO 63303-6631
Phone (636) 875-9901
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 |
|---|---|---|---|
| 077579 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1134484694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3461 BELDEER DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633036631",
"telephone_number": "636-875-9901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2536 S OLD HIGHWAY 94 STE 214",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035612",
"telephone_number": "636-875-9901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "077579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.