Cherisse Thibaut, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2015000976 Issued in MO

Practice address

4 Garden LN
Kirkwood, MO 63122-2636

Phone

(314) 368-0447

NPI assigned

Dec 15, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 15, 2020.

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1952997751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARDEN LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631222636",
            "telephone_number": "314-368-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GARDEN LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631222636",
            "telephone_number": "314-368-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAUT",
        "first_name": "CHERISSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2015000976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jourdyn Tamaray, DPT
• Renee Tate
• Mark Edward Taylor, DMD
• The Mary Culver Home
• The Pink Door Boutique LLC
• Kevin Tompkins
• Total Access Urgent Care, PC
• Transfiguration, Inc.
• Jessica Tu, OD
• Kristine M Tuhill, RPH

• All providers in Kirkwood, MO
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.