Individual provider Active NPI

David C Woodard, LMSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1760504013
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022006745 Issued in MO
Practice address
2653 Locust St
Saint Louis, MO 63103-1411
Phone
(855) 751-8879
Fax
(833) 529-0574
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 2022006745 MO Primary

Addresses

Primary practice location

2653 Locust St
Saint Louis, MO 63103-1411

Mailing address

330 W Court St
Apt. 305
Clay Center, KS 67432-2316
Phone (785) 632-5844

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
I20220705002145 MO Practitioner - Clinical Social Worker 5991185225 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

4625 Lindell Blvd
Suite 200And300
Saint Louis, MO 63108-3725
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022006745MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Oct 13, 2023 Accepting new patients
Vivent Health Inc Current Accepting new patients
Vivent Health Inc CurrentSince May 25, 2024 Accepting new patients
Shiny Triangle LCSW PC Clinical CurrentSince Nov 1, 2023 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

4309 E 50th Ter
Ste 200
Kansas City, MO 64130
Phone (816) 561-8784

107 W 9th St
Fl 2
Kansas City, MO 64105
Phone (505) 382-2776

2653 Locust St
Saint Louis, MO 63103
Phone (314) 645-6451

4625 Lindell Blvd
Ste 200300
Saint Louis, MO 63108
Phone (314) 396-7900

110 Highland Ave
Valley Park, MO 63088
Phone (636) 225-5144

254 Old Nyack Tpke
Spring Valley, NY 10977
Phone (800) 747-4226

648 N Plankinton Ave
Ste 200
Milwaukee, WI 53203

Organizations & group practices 6

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1760504013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W COURT ST",
            "address_2": "APT. 305",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322316",
            "telephone_number": "785-632-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 LOCUST ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031411",
            "telephone_number": "855-751-8879",
            "fax_number": "833-529-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022006745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.