Individual provider Active NPI

Deborah A Reichert, MSW, LCSW

  • Clinical Social Worker
  • Fredericktown, MO
National Provider Identifier
1891704748
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2005039259 Issued in MO
Practice address
735 W Main St
Fredericktown, MO 63645-1113
Phone
(573) 783-8875
Fax
(573) 783-8890
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2005039259 MO Primary

Addresses

Primary practice location

735 W Main St
Fredericktown, MO 63645-1113

Mailing address

735 W Main St
Fredericktown, MO 63645-1113
Phone (573) 783-8875

Other identifiers 1

IdentifierTypeStateIssuer
597560408MedicaidMO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070319000018 MO Practitioner - Clinical Social Worker 4587767249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Missouri, Columbia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

735 W Main St
Fredericktown, MO 63645-1113
Phone (573) 783-8875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005039259MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Associates, Inc CurrentSince Mar 11, 2018 Accepting new patients
Community Health Care Associates, Inc Clinical CurrentSince Mar 11, 2018 Accepting new patients
Residential Psychiatric Services, Inc. Clinical PastSince Jun 12, 2012 Accepting new patients

Locations

735 W Main St
Fredericktown, MO 63645
Phone (573) 747-9703

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1891704748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451113",
            "telephone_number": "573-783-8875",
            "fax_number": "573-783-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451113",
            "telephone_number": "573-783-8875",
            "fax_number": "573-783-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHERT",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005039259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597560408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, MO

Sources for this page

Verify at the official NPI Registry.