Individual provider Active NPI

Patricia F Croughan, MSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1770758260
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
593 Issued in MO
Practice address
130 S Bemiston Ave
Suite 710
Saint Louis, MO 63105-1913
Phone
(314) 863-1007
NPI assigned
Apr 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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 593 MO Primary

Addresses

Primary practice location

130 S Bemiston Ave
Suite 710
Saint Louis, MO 63105-1913

Mailing address

130 S Bemiston Ave
Suite 710
Saint Louis, MO 63105-1913
Phone (314) 863-1007

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
593MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1770758260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S BEMISTON AVE",
            "address_2": "SUITE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051913",
            "telephone_number": "314-863-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BEMISTON AVE",
            "address_2": "SUITE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051913",
            "telephone_number": "314-863-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUGHAN",
        "first_name": "PATRICIA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "593",
            "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 Apr 25, 2008; 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.