Individual provider Active NPI

Aya Branch Kawasaki, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1497926190
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2003026252 Issued in MO
Practice address
3460 Hampton Ave Ste 106
Saint Louis, MO 63139-1938
Phone
(314) 479-1670
Fax
(314) 261-5029
NPI assigned
Mar 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 2003026252 MO Primary

Addresses

Primary practice location

3460 Hampton Ave Ste 106
Saint Louis, MO 63139-1938

Mailing address

3460 Hampton Ave Ste 106
Saint Louis, MO 63139-1938
Phone (314) 479-1670

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
I20080506000059 MO Practitioner - Clinical Social Worker 7315026119 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3460 Hampton Ave
Suite 106
Saint Louis, MO 63139-1938
Phone (314) 445-5678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicultural Counseling and Research Center Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1497926190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 HAMPTON AVE STE 106",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391938",
            "telephone_number": "314-479-1670",
            "fax_number": "314-261-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 HAMPTON AVE STE 106",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391938",
            "telephone_number": "314-479-1670",
            "fax_number": "314-261-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWASAKI",
        "first_name": "AYA",
        "middle_name": "BRANCH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2003026252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.