Individual provider Active NPI

Danielle Rachel Mondloch, LCSW

  • Clinical Social Worker
  • Columbia, MO
National Provider Identifier
1649800533
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2018026061 Issued in MO
Practice address
3501 Berrywood Dr
Columbia, MO 65201-6584
Phone
(844) 853-8937
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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 2018026061 MO Primary

Addresses

Primary practice location

3501 Berrywood Dr
Columbia, MO 65201-6584

Mailing address

3909 Gallant Fox Dr
Columbia, MO 65202-4831
Phone (573) 855-7103

Other names 1

  • Dani Rachel Mondloch Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1649800533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 GALLANT FOX DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652024831",
            "telephone_number": "573-855-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 BERRYWOOD DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016584",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDLOCH",
        "first_name": "DANIELLE",
        "middle_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018026061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANI",
            "last_name": "MONDLOCH",
            "middle_name": "RACHEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.