Individual provider Active NPI

Laura Michelle McClure

  • Clinical Social Worker
  • Desloge, MO
National Provider Identifier
1154858660
Registry record updated May 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1136 N Desloge Dr Ste B
Desloge, MO 63601-2900
Phone
(314) 520-4650
NPI assigned
May 15, 2017
Last updated
May 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1136 N Desloge Dr Ste B
Desloge, MO 63601-2900

Mailing address

3 Cusumano Professional Plaza Dr Ste B
Mount Vernon, IL 62864-6736
Phone (314) 627-0313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831001607 MO Practitioner - Clinical Social Worker 8921404971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

4625 Lindell Blvd
Suite 200And300
Saint Louis, MO 63108-3725
Phone (866) 630-0966

816 S Kirkwood Rd
Suite 105
Kirkwood, MO 63122-6056
Phone (314) 288-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Aug 23, 2021 Accepting new patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Jan 1, 2023 Accepting new patients
Dynamic Counseling and Consultation Services Clinical PastSince Sep 5, 2018 Accepting new patients

Locations

107 W 9th St
Fl 2
Kansas City, MO 64105
Phone (505) 382-2776

4625 Lindell Blvd
Ste 200300
Saint Louis, MO 63108
Phone (314) 396-7900

816 S Kirkwood Rd
Ste 105
Saint Louis, MO 63122
Phone (314) 288-3800

255 Spencer Rd
Ste 201
Saint Peters, MO 63376
Phone (636) 929-2550

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1154858660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CUSUMANO PROFESSIONAL PLAZA DR STE B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646736",
            "telephone_number": "314-627-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 N DESLOGE DR STE B",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636012900",
            "telephone_number": "314-520-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "LAURA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desloge, MO

Sources for this page

Verify at the official NPI Registry.