Individual provider Active NPI

Jennifer A Beebe, LCSW

  • Social Worker
  • Saint Louis, MO
National Provider Identifier
1609937085
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2002023859 Issued in MO
Practice address
8420 Delmar Blvd
Suite 301
Saint Louis, MO 63124-2170
Phone
(314) 872-8898
Fax
(314) 872-8871
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2002023859 MO Primary
Social Worker 104100000X 149010781 IL

Addresses

Primary practice location

8420 Delmar Blvd
Suite 301
Saint Louis, MO 63124-2170

Mailing address

8420 Delmar Blvd
Suite 301
Saint Louis, MO 63124-2170
Phone (314) 872-8898

Other identifiers 1

IdentifierTypeStateIssuer
495917809MedicaidMO

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
I20060328000728 MO Practitioner - Clinical Social Worker 2769490069 Practice locations: Olivette, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9378 Olive Blvd
Olivette, MO 63132-3223
Phone (314) 872-8898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010781ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1609937085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 DELMAR BLVD",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242170",
            "telephone_number": "314-872-8898",
            "fax_number": "314-872-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 DELMAR BLVD",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242170",
            "telephone_number": "314-872-8898",
            "fax_number": "314-872-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEBE",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2002023859",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149010781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495917809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.