Individual provider Active NPI

Kyle Brandt-Lubart, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1750847893
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2020012817 Issued in MO
Practice address
4234 Hydraulic Ave
Saint Louis, MO 63116-4438
Phone
(347) 385-4713
NPI assigned
Feb 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 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 2020012817 MO Primary

Addresses

Primary practice location

4234 Hydraulic Ave
Saint Louis, MO 63116-4438

Mailing address

4234 Hydraulic Ave
Saint Louis, MO 63116-4438
Phone (347) 385-4713

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
I20200702001024 MO Practitioner - Clinical Social Worker 2567885924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4234 Hydraulic Ave
Saint Louis, MO 63116-4438
Phone (347) 385-4713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020012817MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tiny Postcards Counseling & Creative Arts LLC CurrentSince Aug 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1750847893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 HYDRAULIC AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164438",
            "telephone_number": "347-385-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 HYDRAULIC AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164438",
            "telephone_number": "347-385-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT-LUBART",
        "first_name": "KYLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020012817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.