Individual provider Active NPI

Nicole Lynn Marsh, MSW, LCSW, RPT

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1710617402
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2020039453 Issued in MO
Practice address
3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone
(314) 534-9350
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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 2020039453 MO Primary

Addresses

Primary practice location

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101

Mailing address

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 534-9350

Other practice location 1

12 Treecrest Ct
Fenton, MO 63026-3131
Phone (314) 550-7537

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2020039453MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1710617402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391101",
            "telephone_number": "314-534-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391101",
            "telephone_number": "314-534-9350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Treecrest Ct",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630263131",
            "country_code": "US",
            "telephone_number": "314-550-7537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "MSW, LCSW, RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020039453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 6, 2025; 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.