Neoritha Humphrey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1041C0700X Issued in MO

Practice address

1739 Carolyn Park Dr
Saint Louis, MO 63130-1033

Phone

(314) 428-8278

Fax

(314) 428-7670

NPI assigned

Oct 9, 2007

Last updated

Oct 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: neoritha.humphrey.p1@direct.phcenters.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Betty Jean Kerr People's Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1194797787
  Medicare reassignment NPD
• Betty Jean Kerr People's Health Centers

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1679604318
  NPD

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1780872317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 CAROLYN PARK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631301033",
            "telephone_number": "314-482-8278",
            "fax_number": "314-428-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 CAROLYN PARK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631301033",
            "telephone_number": "314-428-8278",
            "fax_number": "314-428-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "NEORITHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW003455",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "1041C0700X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Edward Humphres, LMSW
• Claudia E Humphrey, R.D., L.D., C.D.E.
• Emily Humphrey
• Gracie Humphrey
• Katie Humphrey
• Peter A Humphrey, MD
• William Richard Humphrey II, D.C.
• Benjamin Duane Humphreys, MD
• Judith Lee Humphries, SLP
• Rebecca Marie Wiesehan Hundelt, MD

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.