Active NPI
Luz A Bwanga Mabonghot
- School Social Worker
- Saint Louis, MO
National Provider Identifier
1861295404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573 - Phone
- (314) 267-5967
- NPI assigned
- Mar 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | Primary |
Addresses
Primary practice location
670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573
Mailing address
1801 San Miguel Dr
Saint Charles, MO 63303-3251
Phone (636) 206-0539
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743206400000",
"number": "1861295404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 SAN MIGUEL DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033251",
"telephone_number": "636-206-0539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 MASON RIDGE CENTER DR STE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418573",
"telephone_number": "314-267-5967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BWANGA MABONGHOT",
"first_name": "LUZ",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-29",
"last_updated": "2025-03-29",
"certification_date": "2025-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"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 Mar 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.