Active NPI
Kelly Brook Hogan, LCSW
- Clinical Social Worker
- Saint Louis, MO
National Provider Identifier
1992930325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2007035675
- Practice address
- 5355 Delmar
Saint Louis, MO 63112 - Phone
- (314) 932-7110
- Fax
- (314) 932-7116
- NPI assigned
- May 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2007035675 | MO | Primary |
Addresses
Primary practice location
5355 Delmar
Saint Louis, MO 63112
Mailing address
5355 Delmar
Saint Louis, MO 63112
Phone (314) 932-7110
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007035675 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347840000000",
"number": "1992930325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5355 DELMAR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63112",
"telephone_number": "314-932-7110",
"fax_number": "314-932-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5355 DELMAR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63112",
"telephone_number": "314-932-7110",
"fax_number": "314-932-7116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "KELLY",
"middle_name": "BROOK",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-29",
"last_updated": "2012-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2007035675",
"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 Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.