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General NPI Number Information
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NPI Number | 1235120650
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Entity Type | Individual
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Provider Name | CHERYL L. NIETFELDT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 12166 OLD BIG BEND RD SUITE 100
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City | KIRKWOOD
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State | MO
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Zip | 63122-6844
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Country | US
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Telephone | 314-909-0211
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Fax | 314-909-0323
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Provider Business Mailing Address
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Address Line | 12166 OLD BIG BEND RD SUITE 100
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City | KIRKWOOD
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State | MO
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Zip | 63122-6844
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Country | US
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Telephone | 314-909-0211
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Fax | 314-909-0323
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | R0218
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | R0218
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | R0218
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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Taxonomy #5
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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