1. Home
  2. Directory
  3. Missouri
  4. Saint Louis
  5. Social Worker
  6. NPI Profile

MR. DEANGELO LEON MARDIS JR.
NPI 1104687219
Social Worker - Clinical in Saint Louis, MO

Active since January 17, 2024
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139(314) 206-3700 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Deangelo Leon Mardis Jr. NPPES

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

MR. DEANGELO LEON MARDIS JR. (NPI 1104687219) is an individual clinical provider in Saint Louis, Missouri and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1104687219
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. DEANGELO LEON MARDIS JR.
Location Address3309 S KINGSHIGHWAY BLVDSaint Louis, MO 63139-1101
Mailing Address3309 S Kingshighway BlvdSaint Louis, MO 63139-1101 · (314) 206-3700
Phone(314) 206-3700
Sole ProprietorNo
Enumeration DateJanuary 17, 2024
NPPES CertifiedJanuary 17, 2024
✔ NPI 1104687219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3309 S KINGSHIGHWAY BLVD, Saint Louis, MO 63139
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JEANNA RUFET KNIGHT LPC
Counselor (Professional)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700
CARMEN MARIE MAURO
Case Manager/Care Coordinator
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700
SUMMER JOHNSON
Technician (Personal Care Attendant)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700
MS. DAWN ELIZABETH SWINGER L.P.C.
Counselor (Professional)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 534-9350
CASSIDY SPROCK
Social Worker
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700
BJC BEHAVIORAL HEALTH
Pharmacy (Clinic Pharmacy)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3738
SHYRHA DEDEE DAVIS
Social Worker (Clinical)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700
ASHTYN WILLIAMS
Social Worker (Clinical)
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139
St. Louis City (314) 206-3700

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 Deangelo Mardis's NPI number?

The NPI number for Deangelo Mardis is 1104687219. It was assigned to this individual provider in the NPPES registry on January 17, 2024.

Where is Deangelo Mardis located?

Deangelo Mardis practices at 3309 S Kingshighway Blvd, Saint Louis, MO 63139. The listed phone number is (314) 206-3700.

What is Deangelo Mardis's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Deangelo Mardis was last updated on January 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.