Individual provider Active NPI

Mackenzie L. Lester, MSW, LCSW

  • Clinical Social Worker
  • Saint Peters, MO
National Provider Identifier
1528072832
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2005025550 Issued in MO
Practice address
1284 Jungermann Rd
Saint Peters, MO 63376-6966
Phone
(636) 498-0700
Fax
(636) 498-0050
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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 2005025550 MO Primary

Addresses

Primary practice location

1284 Jungermann Rd
Saint Peters, MO 63376-6966

Mailing address

2451 Executive Dr Ste 205
Saint Charles, MO 63303-5606
Phone (314) 477-6105

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
I20170630001161 MO Practitioner - Clinical Social Worker 0446529606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2451 Executive Dr
Suite 205
Saint Charles, MO 63303-5606
Phone (314) 759-6599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bradke Counseling, LLC Clinical CurrentSince Jun 1, 2018 Accepting new patients
JW Mediation & Therapy, LLC Clinical Past Accepting new patients

Locations

2440 Executive Dr
Ste 210
Saint Charles, MO 63303
Phone (314) 375-6599

2451 Executive Dr
Ste 205
Saint Charles, MO 63303
Phone (314) 375-6599

Organizations & group practices 2

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1528072832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 EXECUTIVE DR STE 205",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035606",
            "telephone_number": "314-477-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766966",
            "telephone_number": "636-498-0700",
            "fax_number": "636-498-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "MACKENZIE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005025550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.