Individual provider Active NPI

Desley Diane Wells, MSW, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1477877520
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2009008718 Issued in MO
Practice address
9107 Big Bend Blvd
Saint Louis, MO 63119-3918
Phone
(314) 762-1905
Fax
(205) 857-7975
NPI assigned
Mar 18, 2010
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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 2009008718 MO Primary

Addresses

Primary practice location

9107 Big Bend Blvd
Saint Louis, MO 63119-3918

Mailing address

9107 Big Bend Blvd
Saint Louis, MO 63119-3918
Phone (636) 399-4075

Other identifiers 1

IdentifierTypeStateIssuer
494164205MedicaidMO

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
I20240118000581 MO Practitioner - Clinical Social Worker 6406208172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009008718MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Reach CurrentSince Dec 12, 2023 Accepting new patients

Locations

3751 Pennridge Dr
Ste 119
Bridgeton, MO 63044
Phone (314) 239-2728

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1477877520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631193918",
            "telephone_number": "636-399-4075",
            "fax_number": "205-857-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9107 BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631193918",
            "telephone_number": "314-762-1905",
            "fax_number": "205-857-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "DESLEY",
        "middle_name": "DIANE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2009008718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494164205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.