Individual provider Active NPI

Anna Constantino-Pettit, M.S.W., L.M.S.W.

  • Social Worker
  • Saint Louis, MO
National Provider Identifier
1174971345
Registry record updated May 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2014019210 Issued in MO
Practice address
660 S Euclid Ave
Campus Box 8134
Saint Louis, MO 63110-1010
Phone
(314) 286-1700
NPI assigned
May 28, 2016
Last updated
May 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2014019210 MO Primary

Addresses

Primary practice location

660 S Euclid Ave
Campus Box 8134
Saint Louis, MO 63110-1010

Mailing address

7732 Gissler Ave
Saint Louis, MO 63117-1523
Phone (618) 610-2684

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
I20230728003169 MO Practitioner - Clinical Social Worker 5991166597 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014019210MOMDSocial Worker

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, 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": "1464393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464393600000",
    "number": "1174971345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 GISSLER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171523",
            "telephone_number": "618-610-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CAMPUS BOX 8134",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-286-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINO-PETTIT",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "M.S.W., L.M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-28",
        "last_updated": "2016-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2014019210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.