Juan Anthony Tabb, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2017004506 Issued in MO

Practice address

9572 Crockett Dr
Saint Louis, MO 63132-2144

Phone

(314) 269-7885

NPI assigned

Mar 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1356882054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9572 CROCKETT DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631322144",
            "telephone_number": "314-269-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9572 CROCKETT DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631322144",
            "telephone_number": "314-269-7885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1032 Crosswinds Ct",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633854836",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABB",
        "first_name": "JUAN",
        "middle_name": "ANTHONY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-14",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2017004506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Lee Tabaka, ANP
• Colleen Marie Tabaka, PNP
• John William Tabash, DDS
• Grace Marie Tabatabai, MD
• Darletta L Tabb
• Vincent Isaihia Tabb
• Adel Bassam Tabchy, MD
• Christopher J. Tabor, P.T.
• Kathryn M Tabor, M.S. CCC-SLP
• Linda A Tackes, MD

• 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 May 3, 2019; 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.