Michelle Suzanne Perotta, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2011036715 Issued in MO

Practice address

12747 Olive Blvd Ste 300
Saint Louis, MO 63141-6269

Phone

(314) 217-6980

NPI assigned

Sep 18, 2023

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

Other names 1

• Michelle Suzanne Jotte Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Conquer the Change Therapy, LLC

  • Social Worker
  • Saint Louis, MO
  • NPI 1679301824
  NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1649058090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12747 OLIVE BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416269",
            "telephone_number": "314-217-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12747 OLIVE BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416269",
            "telephone_number": "314-217-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROTTA",
        "first_name": "MICHELLE",
        "middle_name": "SUZANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2011036715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JOTTE",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joel S Perlmutter, MD
• Monica S Perlmutter, OT
• David Joel Pernikoff, M.D.
• Flavius Gentry Pernoud III, M.D.
• Joan Marie Pernoud, M.D.
• Gary Perotti, CRNA
• Haley N Perotti, PA
• Susan Peroutka, MA CCC-SLP
• Perretta Holisite Services Inc.
• Constance Mayer Perretta, L.M.T.

• Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.