Provider Demographics
NPI:1003501099
Name:BADAMO, CINDY (LCSW)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:BADAMO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 PLYMOUTH ROCK DR
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2034
Mailing Address - Country:US
Mailing Address - Phone:314-600-0218
Mailing Address - Fax:
Practice Address - Street 1:863 PLYMOUTH ROCK DR
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-2034
Practice Address - Country:US
Practice Address - Phone:314-600-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120083491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical