Rachael Blaire Prewett, LPC, LCSW, RPT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2010007508 Issued in MO

Practice address

4156 Avery LN
Bridgeton, MO 63044-3401

Phone

(314) 791-2627

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Rachael Bernstein Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1851456149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4156 AVERY LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630443401",
            "telephone_number": "314-791-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4156 AVERY LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630443401",
            "telephone_number": "314-791-2627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13160 County Road 3610",
            "address_purpose": "LOCATION",
            "city": "St. James",
            "state": "MO",
            "postal_code": "65559",
            "country_code": "US",
            "telephone_number": "573-265-3251 x228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Eagle Ctr Ste B-1",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691946",
            "country_code": "US",
            "telephone_number": "618-726-2041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREWETT",
        "first_name": "RACHAEL",
        "middle_name": "BLAIRE",
        "credential": "LPC, LCSW, RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2004037092",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021891",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010007508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499452902",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "BERNSTEIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Bridgeton, MO
• Providers in Bridgeton, 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 Aug 2, 2022; 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.