Individual provider Active NPI

Geoffrey Schaefer, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1740630748
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2012020097 Issued in MO
Practice address
4121 Union Rd Ste 225
Saint Louis, MO 63129-1093
Phone
(573) 837-2106
Fax
(314) 499-1224
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 2012020097 MO Primary

Addresses

Primary practice location

4121 Union Rd Ste 225
Saint Louis, MO 63129-1093

Mailing address

4121 Union Rd Ste 225
Saint Louis, MO 63129-1093
Phone (573) 837-2106

Other practice location 1

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100 ext. 55409

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
I20160623000685 MO Practitioner - Clinical Social Worker 4183915036 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Missouri, Columbia School of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4121 Union Rd
Saint Louis, MO 63129-1008
Phone (314) 730-6787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012020097MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1740630748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 UNION RD STE 225",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291093",
            "telephone_number": "573-837-2106",
            "fax_number": "314-499-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 UNION RD STE 225",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291093",
            "telephone_number": "573-837-2106",
            "fax_number": "314-499-1224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100 x55409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "GEOFFREY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2012020097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.