Individual provider Active NPI

Kenneth A Barrett, MSW

  • Clinical Social Worker
  • Arnold, MO
National Provider Identifier
1609059468
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW2589 Issued in MO
Practice address
3675 W Outer Rd
Suite 203
Arnold, MO 63010-5232
Phone
(314) 898-0102
Fax
(636) 296-3249
NPI assigned
Dec 14, 2007
Last updated
Jan 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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 SW2589 MO Primary

Addresses

Primary practice location

3675 W Outer Rd
Suite 203
Arnold, MO 63010-5232

Mailing address

2650 Olive St
Saint Louis, MO 63103-1424
Phone (314) 371-6500

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
I20050407000342 MO Practitioner - Clinical Social Worker 6002863461 Reassigns benefits to 1 organization
Practice locations: O Fallon, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom Counseling Mo PCGroup PAC ID 6103264494, 15 clinicians

Practice addresses (Care Compare)

801 S Woodlawn Ave
Suite 16
O Fallon, MO 63366-7647
Phone (636) 379-1779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW2589MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom Counseling Mo, PC CurrentSince Mar 9, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Provident Inc. Clinical Past Accepting new patients

Locations

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

13303 Tesson Ferry Rd
Ste 50
Saint Louis, MO 63128
Phone (314) 729-9995

Interoperability endpoints

  • Direct secure messaging: kennethbarrett@tdh.allscriptsdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1609059468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031424",
            "telephone_number": "314-371-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 W OUTER RD",
            "address_2": "SUITE 203",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630105232",
            "telephone_number": "314-898-0102",
            "fax_number": "636-296-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-14",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.