DR. STACEY WOODROME (NPI# 1689852253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689852253 |
Entity Type | Individual |
Full Name | DR. STACEY WOODROME |
Credential | PH.D. |
Practice Address |
3800 Park Ave Fl 2 Saint Louis MO 63110-2514 |
Practice Telephone | 3145775667 |
Practice Fax Number | 3142682784 |
Mailing Telephone | 3145775667 |
Mailing Fax Number | 3142682784 |
Enumeration Date | 2008-02-06 |
Last Update Date | 2020-11-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | PSY003159 | GA | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1001 Johnson Ferry Rd Ne, Medical Office Building Suite 180, Atlanta, GA 303421605 | 4047851538 | 4047854820 |
Street Address |
3800 PARK AVE FL 2 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63110-2514 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285145367 | Emily Price | Social Worker | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2017-10-17 |
1083125348 | Cheryl Lynn Fromm | Nurse Practitioner | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2017-10-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
Find all providers in zip 63110 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
1700802022 | Nicole J Werner | Clinical Neuropsychologist | 4444 Forest Park Ave Fl 2, 2nd Fl, Saint Louis, MO 63108-2212 | 2006-07-14 |
1477539237 | Rehab Care Group East Inc | Clinical Neuropsychologist | 7733 Forsyth Blvd, Suite 2300, Saint Louis, MO 63105-1817 | 2005-12-22 |
1366910572 | Evan Ti Schulze | Clinical Neuropsychologist | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2018-11-06 |
1912374398 | Victoria Herberger | Clinical Neuropsychologist | 615 S New Ballas Rd, Mercy Neuropsychology Service, Saint Louis, MO 63141-8221 | 2015-09-01 |
1013317700 | Christopher Bosworth | Clinical Neuropsychologist | 1 Childrens Pl, Suite 3n-14, Saint Louis, MO 63110-1002 | 2014-08-29 |
1871929687 | Gabriel Araujo | Clinical Neuropsychologist | 1 Childrens Pl, Suite 3 South 32, Saint Louis, MO 63110-1002 | 2013-09-25 |
1861771206 | Phillip D. Ruppert | Clinical Neuropsychologist | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2011-08-16 |
1992093447 | Angela Nicole Capps | Clinical Neuropsychologist | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2011-07-19 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63110 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.