MEDICARE: CARLY PAIGE VOGT

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1639065410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY PAIGE VOGT

Provider Business Mailing Address
First Line	:	3309 S KINGSHIGHWAY BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1101
Country	:	US
Telephone Number	:	314-206-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S TUCKER BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63102-1152
Country	:	US
Telephone Number	:	314-422-0882
Fax Number	:

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

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/17/2025

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Directions to “ CARLY PAIGE VOGT ” Practice Location

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