Willow Wakeley-Smith, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2024010996 Issued in MO

Practice address

12110 Clayton Rd
Saint Louis, MO 63131-2516

Phone

(314) 989-8242

NPI assigned

Jun 2, 2023

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1326732470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312516",
            "telephone_number": "314-989-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELEY-SMITH",
        "first_name": "WILLOW",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024010996",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Daniel Waite, DDS, MPH, MSD
• Robert Waite, CRNA
• Stuart D Waite, DDS, MBA
• Candace Therese Wakefield, D.M.D
• Patrice Lynn Wakefield, M.D.
• Cynthia Wakil, MD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3061)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2213)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1265)
• Wal-Mart Stores East, LP (Vision Center 30-2213)

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.