Cherie A Baetz-Davis, PH.D.
Individual provider Active NPI Psychologist · Saint Louis, MO
NPI 1366437196 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1366437196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 01638 (MO)
- Practice address
- 331 N New Ballas Rd Unit 410062
Saint Louis, MO 63141-0062 - Phone
- (314) 804-3624
- Fax
- (314) 804-5336
- NPI assigned
- Sep 19, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
331 N New Ballas Rd
Unit 410062
Creve Coeur, MO 63141-5505
Phone (314) 804-3624
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050125000092 | MO | Practitioner - Clinical Psychologist | 2163472515 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherie Baetz-Davis, PH.D., LLC | Psychologist | Current |
Accepting new patients |
| Art Maines, LCSW LLC | Past | Accepting new patients | |
| County of St Louis Division of Fiscal Management | Past | Accepting new patients |
Locations
655 Craig Rd
Ste 128
Saint Louis, MO 63141
Phone (314) 973-2091
331 N New Ballas Rd
Unit 410062
Saint Louis, MO 63141
Phone (314) 804-3624
12645 Olive Blvd
Ste 200
Saint Louis, MO 63141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01638 | MO | Yes |
Addresses
Primary practice location
331 N New Ballas Rd Unit 410062
Saint Louis, MO 63141-0062
Mailing address
211 Carrollton LN
Saint Louis, MO 63135-1225
Phone (314) 804-3624
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 496975814 | Medicaid | MO |
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.