MEDICARE: DR. CHERYL L. NIETFELDT PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	R0218	MO
2	103TC0700X	Clinical Psychologist	R0218	MO
3	103TC2200X	Clinical Child & Adolescent Psychologist	R0218	MO
4	103TB0200X	Cognitive & Behavioral Psychologist
5	103TF0000X	Family Psychologist
6	103T00000X	Psychologist
7	103TM1800X	Intellectual & Developmental Disabilities Psychologist
8	103TC1900X	Counseling Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	487V3	OTHER	MO	BLUE CROSS BLUE SHIELD
2	251558	OTHER	MO	VALUE OPTIONS ID
3	43098515915	OTHER	MO	CMR
4	433774	OTHER	MO	HEALTHLINK
5	6111080	OTHER	MO	UNITED BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1235120650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL L. NIETFELDT PH.D.

Provider Business Mailing Address
First Line	:	12166 OLD BIG BEND RD
Second Line	:	SUITE 100
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-6844
Country	:	US
Telephone Number	:	314-909-0211
Fax Number	:	314-909-0323

Provider Business Practice Location Address
First Line	:	12166 OLD BIG BEND RD
Second Line	:	SUITE 100
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-6844
Country	:	US
Telephone Number	:	314-909-0211
Fax Number	:	314-909-0323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	09/11/2025

Similar Medicare Providers

1245237858 — DR. NORMAN C NEEB DO
Practice Location Address:

12166 OLD BIG BEND RD , STE. 108
KIRKWOOD, MO
63122-6844

Practice Phone: 314-984-0033
Practice Fax: 314-984-0020

1073513222 — DR. WILLIAM EDWARD PEARSON M.D.
Practice Location Address:

12166 OLD BIG BEND RD , STE 306
KIRKWOOD, MO
63122-6844

Practice Phone: 314-984-9977
Practice Fax: 314-984-0441

1588659288 — DR. DAVID LEE OHLMS M.D.
Practice Location Address:

12166 OLD BIG BEND RD , SUITE 100
KIRKWOOD, MO
63122-6844

Practice Phone: 314-909-0211
Practice Fax: 314-909-0323

1437140159 — MRS. TERRI R. OHLMS M.S.W., L.C.S.W.
Practice Location Address:

12166 OLD BIG BEND RD , SUITE 100
KIRKWOOD, MO
63122-6844

Practice Phone: 314-909-0211
Practice Fax: 314-909-0323

1639160062 — CAROLINE PENBERTHY M.S.W., L.C.S.W.
Practice Location Address:

12166 OLD BIG BEND RD , SUITE 100
KIRKWOOD, MO
63122-6844

Practice Phone: 314-909-0211
Practice Fax: 314-909-0323

1184764904 — MID-COUNTY PHYSICIANS, INC.
Practice Location Address:

12166 OLD BIG BEND RD , SUITE 100
KIRKWOOD, MO
63122-6844

Practice Phone: 314-909-0211
Practice Fax: 314-909-0323

Directions to “ DR. CHERYL L. NIETFELDT PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.