Marilyn Maldonado

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

4915 Donovan Ave
Saint Louis, MO 63109-2631

Phone

(314) 481-4095

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Supplemental Health Care

  • Adult Care Home Facility
  • Saint Louis, MO
  • NPI 1902129653
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1215329925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "866-433-9555",
            "fax_number": "314-275-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 DONOVAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092631",
            "telephone_number": "314-481-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MARILYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE HEALTHCARE",
            "identifier": "000076011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malaz Safi, M.D., P.C.
• Louise Cantisano Malburg, MD
• Amber Marie Malcolm, ACNP
• Julie Ann Malcolm, CRNA
• Jonathan Manuel Maldonado, MD
• Mary Kathryn Malecek, MD
• Susanne Marie Malecek, OTRL
• Hamid Malekzadeh Kuradel, MD
• Jill Malen, MS NS APN
• Blair Anthony Malench, PA

• School Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• School Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.