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DR. BRYAN CHARLES DUCKHAM PHD, MSW, LCSW
NPI 1063804821
Social Worker in St. Louis, MO

Active since March 03, 2015PECOS EnrolledAccepts Medicare Assignment
12125 WOODCREST EXEC. DRIVE STE 110, ST. LOUIS, MO 63141(314) 275-8599(314) 275-8299 Get Directions Write a Review

NPPES record last updated: March 3, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Bryan Charles Duckham Phd, Msw, Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRYAN CHARLES DUCKHAM PHD, MSW, LCSW (NPI 1063804821) is an individual social worker in St. Louis, Missouri, licensed in Missouri (366) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1063804821
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameDR. BRYAN CHARLES DUCKHAMCredential: PHD, MSW, LCSW
Location Address12125 WOODCREST EXEC. DRIVE STE 110St. Louis, MO 63141
Mailing Address12125 Woodcrest Exec. Drive Ste 110St. Louis, MO 63141 · (314) 275-8599 · Fax (314) 275-8299
Phone(314) 275-8599
Fax(314) 275-8299
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateMarch 3, 2015
✔ NPI 1063804821 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MO · 366
Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

12125 WOODCREST EXEC. DRIVE STE 110, St. Louis, MO 63141
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Bryan Charles Duckham Phd, Msw, Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658698618
PECOS Enrollment IDI20150331002898
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryan Duckham's NPI number?

The NPI number for Bryan Duckham is 1063804821. It was assigned to this individual provider in the NPPES registry on March 3, 2015.

Where is Bryan Duckham located?

Bryan Duckham practices at 12125 Woodcrest Exec. Drive Ste 110, St. Louis, MO 63141. The listed phone number is (314) 275-8599.

What is Bryan Duckham's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Bryan Duckham enrolled in Medicare?

Yes. Bryan Duckham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Bryan Duckham was last updated on March 3, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.