Individual provider Active NPI

Melinda Dawn East, LCSW

  • Clinical Social Worker
  • Saint Peters, MO
National Provider Identifier
1902955081
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2000161673 Issued in MO
Practice address
7332 Mexico Rd
St. Peters, MO 63376
Phone
(314) 440-1283
Fax
(314) 442-4147
NPI assigned
Jan 9, 2007
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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 2000161673 MO Primary

Addresses

Primary practice location

7332 Mexico Rd
St. Peters, MO 63376

Mailing address

14 Soenker Circle
St. Peters, MO 63376
Phone (314) 440-1283

Other identifiers 2

IdentifierTypeStateIssuer
495263121MedicaidMO
9415365OtherMOPRIVATE HEALTHCARE SYSTEM

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
2000161673MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1902955081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SOENKER CIRCLE",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "314-440-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7332 MEXICO RD",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "314-440-1283",
            "fax_number": "314-442-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAST",
        "first_name": "MELINDA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000161673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495263121",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9415365",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.