DR. STACEY WOODROME


Address: 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514
Phone: 3145775667

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist PSY003159 GA Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1001 Johnson Ferry Rd Ne, Medical Office Building Suite 180, Atlanta, GA 303421605 4047851538 4047854820

Office Location

Street Address 3800 PARK AVE FL 2
City SAINT LOUIS
State MO
Zip Code 63110-2514

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City SAINT LOUIS
Zip Code 63110

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Dataset Information

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.

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