Individual provider Active NPI

Cynthia Marie Eisenbeis, MSW, LCSW

  • Clinical Social Worker
  • Saint Charles, MO
National Provider Identifier
1205883550
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2005040010 Issued in MO
Practice address
223 N Main St
Suite #3
Saint Charles, MO 63301-2828
Phone
(314) 484-6198
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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 2005040010 MO Primary

Addresses

Primary practice location

223 N Main St
Suite #3
Saint Charles, MO 63301-2828

Mailing address

621 Bull Valley Dr
Saint Peters, MO 63304-8544
Phone (314) 484-6198

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
I20070112000239 MO Practitioner - Clinical Social Worker 1557361656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Counseling, LLCGroup PAC ID 2062598600, 10 clinicians

Practice addresses (Care Compare)

1284 Jungermann Rd
Saint Peters, MO 63376-6966
Phone (636) 498-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Counseling, LLC Clinical CurrentSince Dec 1, 2007 Accepting new patients
Innovative Counseling Services, Inc Clinical Past Accepting new patients

Locations

223 N Main St
Ste 3
Saint Charles, MO 63301
Phone (314) 397-3454

1284 Jungermann Rd
Saint Peters, MO 63376
Phone (636) 498-0700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1205883550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 BULL VALLEY DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633048544",
            "telephone_number": "314-484-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "address_2": "SUITE #3",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012828",
            "telephone_number": "314-484-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBEIS",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005040010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.