Active NPI
Cheryl L. Nietfeldt, PH.D.
- Counseling Psychologist
- Kirkwood, MO
National Provider Identifier
1235120650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 12166 Old Big Bend Rd
Suite 100
Kirkwood, MO 63122-6844 - Phone
- (314) 909-0211
- Fax
- (314) 909-0323
- NPI assigned
- Nov 3, 2005
- Last updated
- Sep 11, 2025
- 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 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | R0218 | MO | |
| Psychologist | 103T00000X | NU | ||
| Cognitive & Behavioral Psychologist | 103TB0200X | NU | ||
| Clinical Psychologist | 103TC0700X | R0218 | MO | |
| Counseling Psychologist | 103TC1900X | NU | Primary | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | R0218 | MO | |
| Family Psychologist | 103TF0000X | NU | ||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | NU |
Addresses
Primary practice location
12166 Old Big Bend Rd
Suite 100
Kirkwood, MO 63122-6844
Mailing address
12166 Old Big Bend Rd
Suite 100
Kirkwood, MO 63122-6844
Phone (314) 909-0211
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6111080 | Other | MO | UNITED BEHAVIORAL HEALTH |
| 43098515915 | Other | MO | CMR |
| 487V3 | Other | MO | BLUE CROSS BLUE SHIELD |
| 251558 | Other | MO | VALUE OPTIONS ID |
| 433774 | Other | MO | HEALTHLINK |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0218 | MO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-County Physicians, Inc. | Psychologist | Past | Accepting new patients |
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": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1235120650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12166 OLD BIG BEND RD",
"address_2": "SUITE 100",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226844",
"telephone_number": "314-909-0211",
"fax_number": "314-909-0323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12166 OLD BIG BEND RD",
"address_2": "SUITE 100",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226844",
"telephone_number": "314-909-0211",
"fax_number": "314-909-0323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIETFELDT",
"first_name": "CHERYL",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-03",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "R0218",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "R0218",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MO",
"license": "R0218",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "6111080",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMR",
"identifier": "43098515915",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "487V3",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS ID",
"identifier": "251558",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "433774",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.