Individual provider Active NPI

Marne Anne Meredith, MSW, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1801573738
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023015565 Issued in MO
Practice address
12110 Clayton Rd
Saint Louis, MO 63131-2516
Phone
(314) 989-8100
NPI assigned
Jul 3, 2023
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2023015565 MO Primary
School Social Worker 1041S0200X 1020670 NC

Addresses

Primary practice location

12110 Clayton Rd
Saint Louis, MO 63131-2516

Mailing address

12110 Clayton Rd
Saint Louis, MO 63131-2599
Phone (919) 923-6788

Other practice location 1

1836 Dyer Ave
Saint Louis, MO 63114-2404
Phone (314) 493-6330

Other practice location 2

2634 Sims Ave
Saint Louis, MO 63114-3130
Phone (314) 493-6400

Other practice location 3

3510 Woodson Rd
Saint Louis, MO 63114-4203
Phone (314) 493-6430

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
2023015565MOMDClinical Social Worker
1020670NCMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1801573738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312599",
            "telephone_number": "919-923-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312516",
            "telephone_number": "314-989-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 Dyer Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631142404",
            "country_code": "US",
            "telephone_number": "314-493-6330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2634 Sims Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631143130",
            "country_code": "US",
            "telephone_number": "314-493-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3510 Woodson Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631144203",
            "country_code": "US",
            "telephone_number": "314-493-6430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "MARNE",
        "middle_name": "ANNE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023015565",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NC",
            "license": "1020670",
            "primary": false
        }
    ],
    "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 Aug 13, 2024; 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.