MEDICARE: JOHN GREGORY RAPP MSW, LCSW

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	1041C0700X	Clinical Social Worker	2013014225	MO

General Provider Information

NPI Number	:	1538459086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN GREGORY RAPP MSW, LCSW

Provider Business Mailing Address
First Line	:	271 WYNSTAY AVE
Second Line	:
City	:	VALLEY PARK
State	:	MO
Zip	:	63088-1442
Country	:	US
Telephone Number	:	314-456-9127
Fax Number	:

Provider Business Practice Location Address
First Line	:	13975 MANCHESTER RD STE 2
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63011-4500
Country	:	US
Telephone Number	:	573-424-4808
Fax Number	:

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

Provider Enumeration Date	:	04/17/2011
Last Update Date	:	09/25/2024

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