Individual provider Active NPI

Kevin Wells, MSW, CRAADC

  • Social Worker
  • Saint Louis, MO
National Provider Identifier
1982140463
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
4130 Lindell Blvd
Saint Louis, MO 63108-2914
Phone
(314) 535-5600
NPI assigned
Jan 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3148 MO
Social Worker 104100000X Primary

Addresses

Primary practice location

4130 Lindell Blvd
Saint Louis, MO 63108-2914

Mailing address

4130 Lindell Blvd
Saint Louis, MO 63108-2914
Phone (314) 535-5600

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
3148MOMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1982140463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082914",
            "telephone_number": "314-535-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082914",
            "telephone_number": "314-535-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KEVIN",
        "credential": "MSW, CRAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "3148",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "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 Jan 9, 2017; 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.