Sydney K Greenwalt, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2024019727 Issued in MO

Practice address

1129 Macklind Ave
Saint Louis, MO 63110-1440

Phone

(314) 289-9411

NPI assigned

Jun 12, 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

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

Specialty

Clinical Psychologist

Education

University of Missouri, Kansas City, School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Louis Behavioral Medicine Institute IncGroup PAC ID 3173428638, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• St. Louis Behavioral Medicine Institute Inc

  • Psychologist
  • Saint Louis, MO
  • NPI 1487732335
  Medicare reassignment Care Compare group NPD
• St. Louis Behavioral Medicine Institute Inc

  • Mental Health Counselor
  • Fairview Heights, IL
  • NPI 1952169179
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1578305223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S KINGSHIGHWAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633011695",
            "telephone_number": "636-949-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-289-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALT",
        "first_name": "SYDNEY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2024019727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Greenley, DPT
• Susan Greenplate, LPC
• Aaron B Greenspan, MD
• Rebekah Greenspan, MD
• Chana Greenwald, LPC
• Anna Marie Greenwood, LCSW
• Taylor John Greenwood, MD
• Andrew Thomas Greer, MD
• Karen Greer
• Kayla Greer

• Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.