Individual provider Active NPI

Cynthia Susan Rohlfing Dodson, LCSW

  • Clinical Social Worker
  • Maplewood, MO
National Provider Identifier
1386284065
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004009 Issued in MO
Practice address
2814 Sutton Blvd
Maplewood, MO 63143-3010
Phone
(314) 440-5783
Fax
(314) 781-7914
NPI assigned
Jan 10, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 004009 MO
Professional Counselor 101YP2500X 004009 MO
Social Worker 104100000X 004009 MO
Clinical Social Worker 1041C0700X 004009 MO Primary

Addresses

Primary practice location

2814 Sutton Blvd
Maplewood, MO 63143-3010

Mailing address

1100 Terrace Dr
Saint Louis, MO 63117-1335
Phone (314) 440-5783

Other identifiers 2

IdentifierTypeStateIssuer
1427226612OtherMOOPTUM
1427226612MedicaidMO

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
I20240212002380 MO Practitioner - Clinical Social Worker 3779926217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1386284065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TERRACE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171335",
            "telephone_number": "314-440-5783",
            "fax_number": "314-781-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 SUTTON BLVD",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631433010",
            "telephone_number": "314-440-5783",
            "fax_number": "314-781-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHLFING DODSON",
        "first_name": "CYNTHIA",
        "middle_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "004009",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "004009",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "004009",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "1427226612",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427226612",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MO

Sources for this page

Verify at the official NPI Registry.