Individual provider Active NPI

Lynne Bealke, LCSW

  • Clinical Social Worker
  • Ballwin, MO
National Provider Identifier
1457768657
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2011009309 Issued in MO
Practice address
301 Sovereign CT Ste 211
Ballwin, MO 63011-4435
Phone
(314) 960-2773
NPI assigned
Jul 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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 2011009309 MO Primary

Addresses

Primary practice location

301 Sovereign CT Ste 211
Ballwin, MO 63011-4435

Mailing address

301 Sovereign CT
Ballwin, MO 63011-4441
Phone (314) 960-2773

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2011009309MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1457768657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114441",
            "telephone_number": "314-960-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT STE 211",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114435",
            "telephone_number": "314-960-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALKE",
        "first_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011009309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.