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Contact Information

RICHARD MODDE
5351 DELMAR BLVD
SAINT LOUIS, MO63112-3146
 Phone: 314-877-0589
 Fax: 314-877-0575
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for RICHARD MODDE · (Male)

NPI Number 1013067792
Status Active
Credentials
Entity Individual
Enumeration date 01/12/2007
Last updated 06/09/2008 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 000294
  • MO Medicaid 493735302
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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