Nicole Pondrom, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2023039467 Issued in MO

Practice address

105 Church St
O Fallon, MO 63366-2894

Phone

(636) 294-5787

Fax

(636) 294-5788

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Side by Side Wellness LLC

  • Clinical Social Worker
  • O Fallon, MO
  • NPI 1386112035
  NPD

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1487480141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CHURCH ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662894",
            "telephone_number": "636-294-5787",
            "fax_number": "636-294-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CHURCH ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662894",
            "telephone_number": "636-294-5787",
            "fax_number": "636-294-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDROM",
        "first_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2023039467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Play All Day Pediatric Therapy LLC
• Gwenda Marie Plummer, LPC
• Jessica Plut, P.T.
• Sherri Lin Poettker, DMD
• Jennifer Lynn Ponder
• Blake Ponist, OT
• Abigail Pope, CNM
• Anthony S Pope, DPT
• Linda L Porter, D.P.M.
• Amy Posadas

• Social Worker in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.