Individual provider Active NPI

Nancy L. Phillips-Kuelker, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1437355286
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2000174417 Issued in MO
Practice address
3442 Dunnica Ave
Saint Louis, MO 63118-4222
Phone
(314) 605-9270
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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 2000174417 MO Primary

Addresses

Primary practice location

3442 Dunnica Ave
Saint Louis, MO 63118-4222

Mailing address

3442 Dunnica Ave
Saint Louis, MO 63118-4222
Phone (314) 605-9270

Other identifiers 1

IdentifierTypeStateIssuer
495171621MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1437355286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3442 DUNNICA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184222",
            "telephone_number": "314-605-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3442 DUNNICA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184222",
            "telephone_number": "314-605-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS-KUELKER",
        "first_name": "NANCY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000174417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495171621",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.