Marley Ann Herzog, ACSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW000267 Issued in MO

Practice address

6220 S Lindbergh Blvd
Suite 201
Saint Louis, MO 63123-7802

Phone

(314) 602-6650

Fax

(314) 741-4180

NPI assigned

May 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ann Marley Herzog Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1780895912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 S LINDBERGH BLVD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237802",
            "telephone_number": "314-602-6650",
            "fax_number": "314-741-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 S LINDBERGH BLVD",
            "address_2": "SUITE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237802",
            "telephone_number": "314-602-6650",
            "fax_number": "314-741-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "MARLEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ACSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW000267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "HERZOG",
            "middle_name": "MARLEY",
            "prefix": "MS.",
            "credential": "ACSW, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sophie Alice Hertzler
• Joanne Herzberg, LCSW
• Lisa Simone Herzing, FNP-BC
• Jacques A Herzog, MD
• Lindsey Heather Herzog, LCSW
• Mark Hesker, D.D.S.
• Cory M Heslin, MOST
• Agatha Hess, PT, DPT
• Annie Hess, MD
• Cayce Hess

• 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 Mar 5, 2014; 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.