Individual provider Active NPI

Janet Fabick, MSW, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1659842540
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2018034234 Issued in MO
Practice address
4389 W Pine Blvd
Saint Louis, MO 63108-2205
Phone
(314) 645-6247
Fax
(314) 645-6249
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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 2018034234 MO Primary

Addresses

Primary practice location

4389 W Pine Blvd
Saint Louis, MO 63108-2205

Mailing address

4389 W Pine Blvd
Saint Louis, MO 63108-2205
Phone (314) 645-6247

Other names 1

  • Janet Hanneke Former 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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1659842540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4389 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082205",
            "telephone_number": "314-645-6247",
            "fax_number": "314-645-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082205",
            "telephone_number": "314-645-6247",
            "fax_number": "314-645-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABICK",
        "first_name": "JANET",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018034234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "HANNEKE",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.