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NPI Code Detail

MEDICARE: GARRETT LCSW & CONSULTING, L.L.C.

MEDICARE: GARRETT LCSW & CONSULTING, L.L.C.
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
11041C0700XClinical Social Worker8370-123WI
21041C0700XClinical Social WorkerLC50080815DC
31041C0700XClinical Social Worker2011008912MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700176310
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARRETT LCSW & CONSULTING, L.L.C.
Provider Business Mailing Address
First Line : 4625 LINDELL BLVD FL 2
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3739
Country : US
Telephone Number : 314-866-8116
Fax Number : 314-639-9996
Provider Business Practice Location Address
First Line : 4625 LINDELL BLVD FL 2
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3739
Country : US
Telephone Number : 314-866-8116
Fax Number : 314-639-9996
Authorized Official
Title or Position : OWNER/CHIEF EXECUTIVE OFFICER
Name : DR. ERNEST EDWARD GARRETT III
Credential : LCSW, LICSW
Telephone Number : 314-866-8116
Provider Enumeration Date : 04/15/2011
Last Update Date : 05/11/2024

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