Individual provider Active NPI

Chardial Samuel, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1245029230
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5236 Helen Ave
Saint Louis, MO 63136-3411
Phone
(314) 732-8841
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

5236 Helen Ave
Saint Louis, MO 63136-3411

Mailing address

5236 Helen Ave
Saint Louis, MO 63136-3411
Phone (314) 732-8841

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
I20250609000337 MO Practitioner - Clinical Social Worker 0244740322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mypathtoself IncGroup PAC ID 4082088323, 11 clinicians

Practice addresses (Care Compare)

12818 Tesson Ferry Rd
Suite 103
Saint Louis, MO 63128-2945
Phone (314) 923-4655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004590MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mypathtoself Inc. CurrentSince May 28, 2025 Accepting new patients

Locations

12818 Tesson Ferry Rd
Ste 103
Saint Louis, MO 63128
Phone (314) 912-4655

2464 Taylor Rd
Wildwood, MO 63040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1245029230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5236 HELEN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631363411",
            "telephone_number": "314-732-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 HELEN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631363411",
            "telephone_number": "314-732-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "CHARDIAL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.