Healthcare Provider Details

I. General information

NPI: 1649781998
Provider Name (Legal Business Name): TODD M CADELL LCSW MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 HEMINGWAY LN
WELDON SPRING MO
63304-8176
US

IV. Provider business mailing address

1 JEFFERSON BARRACKS DR BLDG 51
SAINT LOUIS MO
63125-4181
US

V. Phone/Fax

Practice location:
  • Phone: 636-734-9444
  • Fax:
Mailing address:
  • Phone: 314-652-4100
  • Fax: 314-845-5089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00494
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: