Individual provider Active NPI

Julia F Covilli, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1902475718
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2024024473 Issued in MO
Practice address
1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405
Phone
(314) 275-8599
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 2024024473 MO Primary

Addresses

Primary practice location

1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405

Mailing address

2306 Saint Robert LN
Saint Charles, MO 63301-1448
Phone (662) 609-7045

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
I20241007002657 MO Practitioner - Clinical Social Worker 5991236564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Washington College of Physicians and Surgeons, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Madmar LLCGroup PAC ID 8628516119, 9 clinicians

Practice addresses (Care Compare)

1215 Fern Ridge Pkwy
Suite 110
Saint Louis, MO 63141-4405
Phone (314) 275-8599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024024473MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fitzgibbons Psychological West County Psychological Associates CurrentSince Sep 11, 2024 Accepting new patients
Madmar, LLC Social Worker CurrentSince Sep 11, 2024 Accepting new patients

Locations

1215 Fern Ridge Pkwy
Ste 110
Saint Louis, MO 63141
Phone (314) 275-8599

1215 Fern Ridge Pkwy
#110W
Saint Louis, MO 63141
Phone (314) 275-8599

Organizations & group practices 2

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": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1902475718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 SAINT ROBERT LN",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633011448",
            "telephone_number": "662-609-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 FERN RIDGE PKWY STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631414405",
            "telephone_number": "314-275-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVILLI",
        "first_name": "JULIA",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024024473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.