Active NPI
Haley Danielle Fitzgibbons, MSW, LCSW
- Clinical Social Worker
- Saint Louis, MO
National Provider Identifier
1518634997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2022001102
- Practice address
- 12110 Clayton Rd
Saint Louis, MO 63131-2599 - Phone
- (314) 669-4406
- NPI assigned
- Aug 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 2019010860 | MO | |
| Clinical Social Worker | 1041C0700X | 2022001102 | MO | Primary |
Addresses
Primary practice location
12110 Clayton Rd
Saint Louis, MO 63131-2599
Mailing address
12110 Clayton Rd
Saint Louis, MO 63131-2599
Phone (314) 669-4406
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2022001102 | MO | MD | Clinical Social Worker |
| 2019010860 | MO | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1518634997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12110 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312599",
"telephone_number": "314-669-4406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12110 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312599",
"telephone_number": "314-669-4406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGIBBONS",
"first_name": "HALEY",
"middle_name": "DANIELLE",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-24",
"last_updated": "2022-01-13",
"certification_date": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MO",
"license": "2019010860",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2022001102",
"primary": true
}
],
"identifiers": [],
"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 Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.